- Molina Healthcare (Roswell, NM)
- **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 (Roswell, NM)
- …+ Monitors RFC submission mailbox, submit RFCs in iServe, and notify the Analyst of completion. + Researches and reviews MRDT issues identified by the HPs ... MCG functionality. Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. + Complex requirements with… more
- Community Health Systems (Roswell, NM)
- …office at Eastern New Mexico Medical Center.** **Job Summary** The Financial Analyst I is responsible for analyzing financial data, preparing reports, and assisting ... information, monitoring trends, and ensuring financial data integrity. The Financial Analyst I collaborates with leadership and department managers to provide… more
- Molina Healthcare (Roswell, NM)
- **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
- Community Health Systems (Roswell, NM)
- **Job Summary** The HIM Analyst is responsible for supporting the management and accuracy of patient health information, auditing health records, and ensuring ... compliance with regulatory requirements. This role helps maintain the integrity of the electronic health record (EHR) system, collaborates with cross-functional teams, and provides data analysis to enhance health information processes. **What We Offer:** +… more
- Molina Healthcare (Roswell, NM)
- **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting ... solutions to assist HEDIS Outbound, Inbound extracts, Data Ingestions, Dashboards, Reports & Extracts for rate tracking and other outreach purposes. **ESSENTIAL JOB DUTIES:** *Mentors and leads 2-10 software engineers on multiple projects for project… more
- Molina Healthcare (Roswell, NM)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... develops reporting solutions to assist HEDIS audit, rate tracking, and Identifying targeted Interventions and tracking outcome. Assist with research, development, and completion of special performance improvement projects. **ESSENTIAL JOB DUTIES:** + Work… more
- Molina Healthcare (Roswell, NM)
- JOB DESCRIPTION Job Summary Provides entry level analyst support for clinical information systems activities. Responsible for provision of application technical ... support and design for clinical information systems - ensuring creation of workflows and enhancements that support process improvement and change management initiatives. Contributes to overarching strategy to provide quality and cost-effective member care.… more
- Molina Healthcare (Roswell, NM)
- JOB DESCRIPTION Job Summary Provides analyst support for actuarial function activities including extracting, analyzing, and synthesizing data from various sources to ... identify risks. Estimates liabilities, establishes premium rates, and supports financial analysis and reporting. **Essential Job Duties** * Collaborates with actuarial team to complete incurred but not reported (IBNR) estimates and rate adequacy studies, and… more
- Molina Healthcare (Roswell, NM)
- …emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst , Data is responsible for data compilation, data management, data ... analysis, and reporting - using SQL and PowerBI + Extracts and compiles various sources of information and large data sets from various systems or applications + Set up process for monitoring, tracking and trending information and data using various systems or… more
- Molina Healthcare (Roswell, NM)
- …emerging technologies. **KNOWLEDGE/SKILLS/ABILITIES** + With limited supervision, the Sr. Analyst , Data is responsible for data compilation, data management, data ... analysis, and reporting + Extracts and compiles various sources of information and large data sets from various systems or applications + Set up process for monitoring, tracking and trending information and data using various systems or applications + Prepares… more
- Molina Healthcare (Roswell, NM)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality care with improved outcomes through better coordination and preventive care and develop payment strategies that give incentives… more
- Molina Healthcare (Roswell, NM)
- JOB DESCRIPTION Job Summary Provides entry level analyst support for provider configuration activities including accurate and timely maintenance of critical provider ... information on all claims and provider databases. Synchronizes data within multiple claims systems and validates data stored within provider databases - ensuring adherence to business and system requirements as it pertains to contracting, network management… more
- Molina Healthcare (Roswell, NM)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... analysis to ensure access to quality healthcare services for people receiving government assistance. Strengthens access to quality care with improved outcomes through better coordination and preventive care and develop payment strategies that give incentives… more
- Molina Healthcare (Roswell, NM)
- …**Job Summary** Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on ... claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it… more
- Molina Healthcare (Roswell, NM)
- …**Job Summary** The role is responsible for assisting in establishing premium rates and conducting financial analysis and reporting. A key responsibility of this role ... is supporting the Molina Marketplace ACA individual market pricing, forecasting, and accrual processes. **Essential Job Duties** * Supports the development of incurred but not reported (IBNR) estimates and rate adequacy studies, and documents assumptions. *… more
- Molina Healthcare (Roswell, NM)
- …**Job Summary** Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not ... limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where… more
- Molina Healthcare (Roswell, NM)
- …**Job Summary** 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 apply to each database. Validate accuracy of configuration and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Molina Healthcare (Roswell, NM)
- …**Job Summary** Serves as a subject matter expert on system capabilities, conducting research and root cause analysis to resolve complex business and technical ... issues. Ensures system configuration aligns with business rules, regulatory requirements, and operational needs. Supports upgrades, releases, and health plan implementations while validating data integrity and recommending improvements to enhance system… more
- Molina Healthcare (Roswell, NM)
- …**Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, ... estimate risk scores, and analyze impact. Extract, analyze, and synthesize data from various sources to identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is… more