- Cognizant (Austin, TX)
- About the role As a ** Quality Analyst with Healthcare - Claims & Membership experience** . You will make an impact by designing and executing end-to-end ... test strategies that ensure the quality and reliability of healthcare claims and membership applications. You will be a valued member of the Quality … more
- Molina Healthcare (Austin, TX)
- **Job Description** **Job Summary** Provides entry level analyst support for claims research activities. This role plays a pivotal role in ensuring the timely ... and quality standards. **Job Duties** + Reviews and analyzes claims -related issues submitted by providers to identify potential root causes quickly and… more
- Molina Healthcare (Austin, TX)
- …and work PST hours. **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant… more
- Molina Healthcare (Austin, TX)
- …Microsoft Azure, AWS or Hadoop. * 3-5 Years of experience with predictive modeling in healthcare quality data. * 5+ Years of experience in Analysis related to ... **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates * Assists and… more
- Molina Healthcare (Austin, TX)
- …Microsoft Azure, AWS or Hadoop. + 1-3 Years of experience with predictive modeling in healthcare quality data. + 1-3 Years of experience in Analysis related to ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement...Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS measure deep dive to support… more
- Molina Healthcare (Austin, TX)
- …Responsible for accurate and timely auditing of critical information on claims databases. Maintains critical auditing and outcome information. Synchronizes data ... among operational and claims systems and application of business rules as they...to meet changing business requirements, strong commitment to high quality , on time delivery + Previous process improvement experience… more
- Evolent (Austin, TX)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Molina Healthcare (Austin, TX)
- **Job Description** **Job Summary** The Lead Analyst , Reimbursement is responsible for administering complex provider reimbursement methodologies timely and ... existing lines of business and expansion into new states. The Lead Analyst , Reimbursement will be primarily responsible for implementation, maintenance, and support… more
- Molina Healthcare (Austin, TX)
- …network partners through contract valuation and analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens ... **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the...affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary)… more
- Molina Healthcare (Austin, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... improvement processes to ensure systems are working more efficiently and improve quality . + Assists in planning and coordination of application upgrades and… more
- Molina Healthcare (Austin, TX)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... accuracy in a timely manner to meet department standards of turnaround time and quality . + Audit loaded provider records for quality and financial accuracy and… more
- Molina Healthcare (Austin, TX)
- …accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information (using SQL, PowerBI, ... and Excel) on all claims and provider databases. Synchronizes data among multiple ...and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.… more
- Prime Therapeutics (Austin, TX)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Molina Healthcare (Austin, TX)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... management and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous quality of provider data and developing SOPs and/or BRDs. +… more
- Molina Healthcare (Austin, TX)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Audits loaded provider records for quality and financial accuracy and provides documented feedback. + Assists… more
- Prime Therapeutics (Austin, TX)
- …analysis to include 1 year of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Must be eligible to ... our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - REMOTE **Job Description** The Pricing Analyst maintains, provides… more
- Evolent (Austin, TX)
- … quality reporting, and benchmarking + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing and ... that fosters expertise and cooperation + Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data regarding health plan cost &… more
- Norstella (Austin, TX)
- …seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. In this role, you will leverage your expertise in healthcare ... Sr. Medical Analyst , RWD Company: MMIT Location: Remote, United States...related field. + Experience working with and querying large healthcare databases, including claims , EMR/EHR, and laboratory… more
- Prime Therapeutics (Austin, TX)
- …experience, preferably leveraging AI + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... decision we make. **Job Posting Title** Data & Reporting Analyst Principal - Remote **Job Description** The Principal Data...Experience in the implementation of quality process improvement efforts Every employee must understand, comply… more
- Humana (Austin, TX)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more