- Zelis (TX)
- …We are seeking a detail-oriented and technically skilled analyst to support healthcare claims repricing and data validation efforts. In this role, ... data -driven insights. Success in this role requires deep familiarity with healthcare claims data , strong SQL proficiency, and a solid understanding of… more
- Molina Healthcare (TX)
- …solution or configuration during warranty period. **KNOWLEDGE/SKILLS/ABILITIES** + Knowledge of healthcare claims and claim processing from receipt through ... functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received… more
- Molina Healthcare (Fort Worth, TX)
- …+ Locate and interpret regulatory and contractual requirements + Tailors existing reports or available data to meet the needs of the claims project + Evaluates ... **Job Description** **Job Summary** Serves as claims subject matter expert. Assist the business teams...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Providence (TX)
- …insurance codes, regulations, and our department's policies and procedures + Secure monthly claims data reports and provide quality assurance recommendations to ... claims files for quality assurance purposes + Experience working with claims data analytics + Experience in project management + Experience creating… more
- Molina Healthcare (Austin, TX)
- …of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Carrington (Plano, TX)
- …amazing team and work remote from home! The Loss Claim Recovery Analysis Analyst is responsible for performing financial reconciliation on all liquidated loans and ... external investors providing opportunity for investor rebuttals. Accountable for analyzing multiple data elements in order to apply the proper decision rationale and… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **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… more
- Centene Corporation (Austin, TX)
- …of care for members and improve their clinical outcomes. + Interpret and analyze data from multiple sources including claims , provider, member, and encounters ... and data management or 2+ years of IT experience. Healthcare analytics experience preferred. Working knowledge of SQL/querying languages. Preferred knowledge of… more
- Methodist Health System (Dallas, TX)
- …:** **Days Of Week :** **Work Shift :** **Job Description :** **Insurance Risk Analyst ** **Mission and Vision.** Methodist Health System (MHS) is a $2 billion health ... is to improve and save lives through compassionate, quality healthcare . We strive to be the trusted choice for...search for an individual to fill the Insurance Risk Analyst position. The role will directly support the Corporate… more
- Scottish Rite for Children (Dallas, TX)
- …priority! We're committed to giving children back their childhood! Job Posting Title: Data Analyst Lead Location: Dallas - Hospital Additional Posting Details: ... Monday - Friday 8:30am - 4:30pm Job Description: Duties/Responsibilities + Query healthcare data from multiple sources including electronic medical records,… more
- Molina Healthcare (TX)
- …Marketplace and Medicare/MMP + Develops custom health plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and ... **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's...reports as requested to track HEDIS performance and supplemental data monitoring + Develops and QA custom health plan… more
- Molina Healthcare (Fort Worth, TX)
- …of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule… more
- Evolent (Austin, TX)
- …BI, Excel, SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data + Working on a strategic analytics team ... succinctly + 2 or more years of experience within a healthcare analytics role, working with Claims , Membership, or Authorization Data , and consulting both… more
- Molina Healthcare (TX)
- …all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims ... systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and… more
- Molina Healthcare (San Antonio, TX)
- …translate them into comprehensive business and functional specifications. + Analyze complex healthcare data sets to identify trends, patterns and insights that ... all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims … more
- Molina Healthcare (TX)
- …of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...Benefits and contracts configuration in QNXT + Must have claims processing experience + Knowledge is SQL + Experience… more
- Molina Healthcare (Houston, TX)
- …education is acceptable. **REQUIRED EXPERIENCE:** + 1-3 years of experience in Healthcare (payer experience), Vendor Management, Data Analytics, Contract Terms ... **Job Summary** Supports ongoing Claims and Enrollment operations in the management of...analyze business and vendor performance problems and issues using data from internal and external sources to provide solutions… more
- Evolent (Austin, TX)
- …- Preferred + Professional experience in healthcare analytics (eg medical and pharmacy claims data , membership data , or other healthcare data ... the culture. **What You'll Be Doing:** **Job Posting: Senior Analyst , Performance Analytics** **Location: Remote** Evolent is seeking a...to tackle some of the most significant challenges in healthcare . By working closely with Data Science,… more
- Evolent (Austin, TX)
- …**What You Will Be Doing:** + ** Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Prime Therapeutics (Austin, TX)
- …Recommend new and revised financial pricing strategies based on analysis of pharmacy claims data , average wholesale drug prices (AWP), health plan margin target ... markets + Interpret financial performance reports to monitor performance against pharmacy claims data and identify financial pricing opportunities to drive… more