- AIG (Dallas, TX)
- Senior Claims Management Analyst Join us as a Senior Claims Analyst to grow your experience in handling complex claims . Make your mark in ... to ensure accuracy of financial exposure. Identifies and makes reserve recommendations to management on claims evaluated greater than assigned authority. + Works… more
- Highmark Health (Austin, TX)
- …medical terminology **Preferred:** + 3 years of experience in a Stop Loss Claims Analyst role. **SKILLS** + Ability to communicate concise accurate information ... as current issues regarding client activities; disseminates necessary information to the management . Follows up on pended claims in accordance with department… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The ** Senior Analyst , Utilization Management ** plays a critical role in supporting clinical and ... into technical solutions. This role works closely with clinicians, utilization management teams, and business stakeholders to gather requirements and deliver… more
- Prime Healthcare (Farmers Branch, TX)
- … Management by analyzing data and identifying process improvement opportunities. The Senior Analyst will apply analytical and critical thinking to develop ... As the Subject Matter Expert (SME) for Revenue Cycle operations, the Senior Analyst will lead strategic project implementations. Additionally, this position… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management , Network, and other departments to enable critical… more
- Molina Healthcare (Austin, TX)
- …to management , including recommendations for any identified finding; Supports management with presenting results and recommendations to Senior Leadership and ... to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr. Analyst works with health plans and operations departments to assess, oversee,… more
- Evolent (Austin, TX)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team provides a ... the impact of our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will support both internal teams… more
- Molina Healthcare (Austin, TX)
- **Job Description** **Job Summary** The Sr Analyst , Encounters is responsible for monitoring inbound and outbound encounter processes and ensuring timely, accurate, ... rejection inventory, and works with other areas including IT, health plan, claims , provider, enrollment, regulators, and external vendors, as needed, to remediate… 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 ... requirements of customers as it pertains to contracting, network management and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous… more
- US LawShield (Houston, TX)
- …as well as collaboratively in a fast-paced environment. + Knowledge of CRM, claims management systems, or member services analytics. Powered by JazzHR ... in their self-defense journey. US LawShield is seeking a Senior Data Analyst to join our data...platforms. + Conduct in-depth analyses of member engagement, retention, claims , and operational performance to identify trends, risks, and… more
- Elevance Health (Grand Prairie, TX)
- **Provider Contract Cost of Care Analyst Senior ** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... accommodation is granted as required by law. The **Provider Contract Cost of Care Analyst Senior ** is responsible for providing analytical support to the Cost of… more
- Molina Healthcare (Houston, TX)
- …easy to understand. + Research and develop reports and analysis for senior management and effectively communicate results. **JOB QUALIFICATIONS** **Required ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will support Molina's Risk...analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue,… more
- Highmark Health (Austin, TX)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- Keurig Dr Pepper (Frisco, TX)
- …hours, including evenings, weekends, and holidays. Join Keurig Dr Pepper as a Senior Global Logistics Analyst , where you'll manage international import and ... while driving strategic initiatives. This role blends hands-on logistics management with analytical decision-making to ensure cost-effective, compliant, and… more
- Molina Healthcare (San Antonio, TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... **Required Experience** + 5-7 years increasingly complex database and data management responsibilities + 5-7 years of increasingly complex experience in quantifying,… more
- CVS Health (TX)
- …every day. **Position Summary** CVS Health is looking for an experienced Business Analyst , QA and Technical SME with focus on balancing high-impact business ... management solutions with small project speed to market efficiency....+ Healthcare Insurance and PBM knowledge including Prior Authorizations, Claims , Rebates, Network contracting, Sales, Call Center Ops and… more
- Intermountain Health (Austin, TX)
- …sustaining business processes and processes impacted by data and systems. The business analyst serves as the central point for interface changes for systems and ... partner exchanges. **Essential Functions** + Participates in Business Process Management (BPM) including modeling processes using various notations (ie, BPMN),… 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 custom ... + Develops custom health plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and collaborates with the national… more
- Prime Therapeutics (Austin, TX)
- …team, business stakeholders, development team, broader project team and various levels of management . With consistent Senior Leadership visibility, the IT BSA Sr ... plan and detailed estimate based on scope; lead scope management , prioritization and drive scope trade off discussions with...assignments within project + Educate and advance business systems analyst practice within the Claims IT team… more
- Defense Logistics Agency (Fort Sam Houston, TX)
- …the region. Requirements Conditions of Employment Qualifications To qualify for a Management and Program Analyst , your resume and supporting documentation must ... new or modifies work methods, organizational structures, records, files, management processes, staffing patterns, procedures for administering program services,… more