- JS Perkins Consulting (San Antonio, TX)
- …Here is the Role: JS Perkins Consulting (JSPC) is seeking to hire a Budget Analyst to support the Defense Health Agency (DHA) Office of General Counsel (OGC) in its ... improve financial oversight and increase collections through the Medical Affirmative Claims (MAC) and Third-Party Collections (TPC) programs. This role will provide… more
- 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 (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 (Fort Worth, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... business requirements. Lead and participate in audit initiatives, develop quality control framework, and collaborate cross-functionally to drive continuous… 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 (TX)
- **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... on how to use reports related to Risk and Quality /HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research,...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and… 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 (TX)
- …Knowledge of healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...related to cost, utilization and revenue for multiple Molina Healthcare products. Designs and develops reports to monitor health… more
- Molina Healthcare (Dallas, TX)
- …proficiency in SQL for large dataset analysis and transformation, specifically in processing healthcare claims data and supporting managed care reporting needs + ... solutions. * Write advanced SQL queries to extract, validate, and analyze healthcare data, including claims , authorization, pharmacy, and lab datasets. *… more
- Molina Healthcare (San Antonio, 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 (Fort Worth, 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 (Dallas, 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)
- …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
- 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
- Centene Corporation (Austin, TX)
- …clinical outcomes. + Interpret and analyze data from multiple sources including claims , provider, member, and encounters data. Identify and assess the business ... economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience.… more
- Molina Healthcare (Houston, 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
- Molina Healthcare (Dallas, TX)
- **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides ... Reviews and analyzes gaps to improve organizational processes, and works to improve quality , productivity, and efficiency in partnership with the team and the vendor… more
- Prime Therapeutics (Austin, TX)
- …data consolidation and modeling + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + Experience ... and drives every decision we make. **Job Posting Title** Data and Reporting Analyst Assoc- REMOTE **Job Description** The Associate Data & Reporting Analyst … more
- Elevance Health (Grand Prairie, TX)
- …to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and ... **Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to...of care issues to help reduce costs without compromising quality of care. **How you will make an impact:**… more
