- Deloitte (Houston, TX)
- …accordance with established medical and legal requirements + Interact with healthcare professionals to provide report-specific feedback and assist in resolving ... / personal health information + Consistently meet individual productivity and quality goals The Team Deloitte's Government and Public Services (GPS) practice… more
- Molina Healthcare (Houston, 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 (Houston, TX)
- …up process for monitoring, tracking, and trending department data, including quality measures, effectiveness of communications, and process improvements. + Works ... equivalent combination of education and experience **Preferred Experience** 3-5 year Quality and/or Medicare Stars knowledge highly preferred To all current Molina… more
- Molina Healthcare (Houston, 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...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Molina Healthcare (Houston, 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...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Molina Healthcare (Houston, TX)
- …business requirements. Lead and participate in audit initiatives, develop quality control framework, and collaborate cross-functionally to drive continuous ... internal policies and external regulations. + Develop and maintain audit checklists, quality metrics, and reporting tools. + Identify configuration errors and root… more
- Molina Healthcare (Houston, TX)
- …a related field **PREFERRED EXPERIENCE:** 7-9 years of experience as a Business Analyst ; healthcare industry strongly preferred To all current Molina employees: ... **Job Description** **Job Summary** The Sr. Analyst , Advanced Provider Data Management is responsible for...into comprehensive business and functional specifications. * Analyze complex healthcare data sets to identify trends, patterns and insights… more
- Molina Healthcare (Houston, TX)
- **Job Description** **Job Summary** The Lead Analyst , Advanced Provider Data Management is responsible for analyzing and understanding business processes, ... technical expertise, and the ability to mentor and support other analysts. The Lead Analyst often acts as a liaison between the business units and IT, ensuring that… more
- Molina Healthcare (Houston, TX)
- **JOB DESCRIPTION** **JOB DESCRIPTION** **Job Summary** The **Senior Analyst , Utilization Management** plays a critical role in supporting clinical and operational ... initiatives by translating healthcare business needs into technical solutions. This role works...and cost drivers across the organization. * Ensure data quality , governance, and documentation standards are met in all… more
- Molina Healthcare (Houston, 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
- Elevance Health (Houston, TX)
- **Performance Quality Analyst II** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... for employment, unless an accommodation is granted as required by law. The **Performance Quality Analyst II** is responsible for driving service quality … more
- Molina Healthcare (Houston, TX)
- …software engineers on multiple projects for project deliverables, assess deliverables' quality , plan and implement corrective and preventive actions to improve ... application quality . * Evaluates alternative systems solutions and recommends solution...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Molina Healthcare (Houston, TX)
- …areas. + Quality review and submission of deliverables to Molina Healthcare Government Contract and to State Medicaid Agencies. + Tracking all contractual ... complex enrollment issues concerning member eligibility. + QNXT + Healthcare experience + SQL-preferred **Job Qualifications** **Required Education** Associate's… more
- Molina Healthcare (Houston, TX)
- …software engineers on multiple projects for project deliverables, assess deliverables' quality , plan, and implement corrective and preventive actions to improve ... application quality . + Perform Business Role Analysis and oversee the...position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina… more
- Molina Healthcare (Houston, TX)
- …management and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Generates data to support continuous quality of provider data and developing SOPs and/or BRDs. + ... improvement processes to ensure systems are working more efficiently and improve quality . + Assists in planning and coordination of the claim payment system… more
- Molina Healthcare (Houston, TX)
- …data integrity and recommending improvements to enhance system efficiency and quality . **KNOWLEDGE/SKILLS/ABILITIES** + Serves as a subject matter expert (SME) on ... to ensure systems are working more efficiently and improve quality . + Assists in planning and coordination of application...experience in QNXT or NetworX Pricer + Must have healthcare experience. + Experience working with SQL is highly… more
- Molina Healthcare (Houston, TX)
- …accuracy in a timely manner to meet department standards of turnaround time and quality . + Audit loaded provider records for quality and financial accuracy and ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Molina Healthcare (Houston, TX)
- …improvement processes to ensure systems are working more efficiently and improve quality . + Assists in planning and coordination of application upgrades and ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Molina Healthcare (Houston, TX)
- …and credentialing. **KNOWLEDGE/SKILLS/ABILITIES** + Audits loaded provider records for quality and financial accuracy and provides documented feedback. + Assists ... for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare … more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Senior (Sr.) Business Analyst is responsible for being a key facilitator within the organization, acting as a bridge between the client, ... stakeholders and assigned team. The Sr. Business Analyst is responsible for large scale projects of advanced complexity and scope. Responsible for identifying the… more