- Humana (Austin, TX)
- …our organization's standing within the Medicaid markets. **Complex Ad-Hoc Requests:** The Data and Reporting Professional 2 will address complex ad-hoc ... caring community and help us put health first** The Medicaid Data and Reporting Analyst...operating objectives, including their linkages to related areas. The Data and Reporting Professional 2… more
- Humana (Austin, TX)
- …of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, completeness, and ... Requires strong project management skills to evaluate the downstream impacts of data changes on actuarial models, reporting tools, and financial results.… more
- Health Care Service Corporation (Richardson, TX)
- …clients., large employers, brokers, or consultants. + 7 years experience requiring data analysis and information reporting relating to healthcare data ... and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for planning, managing and… more
- Humana (Austin, TX)
- …and Medicaid program requirements to drive accurate and timely submissions. The Senior Data and Reporting Professional integrates data from multiple ... operations across multiple states. This role ensures compliance with state-specific Medicaid reporting implementations and requirements, will collaborate with… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Senior Data & Reporting Professional tests the overall network in each county of ... requires an in-depth evaluation of variable factors. The Senior Data & Reporting Professional begins...Adequacy requirements and process optimization, primarily focusing on the Medicaid line of business, with a deep understanding of… more
- Houston Methodist (Houston, TX)
- …reports, Federal Tax Returns Health and Human Services (HHS)/Centers for Medicare and Medicaid Services (CMS) reporting , Federal and State Charity Reporting , ... regulations. **Preferred candidates will have the following:** Medicare and Medicaid Cost Reporting **PEOPLE ESSENTIAL FUNCTIONS** + Directs,… more
- Humana (Austin, TX)
- …contracting requirements and data integrity as required in the Ohio Medicaid Provider Agreement and internal reporting compliance. This role will support ... contracting governance, process development, and data governance Ohio Medicaid , including developing contracting requirements, internal reporting compliance… more
- Houston Methodist (Houston, TX)
- …and seek maximum reimbursement from various government programs. The Sr. Accounting and Reporting Analyst utilizes strong data analytic skills to identify issues ... At Houston Methodist, the Senior (Sr.) Accountng and Reporting Analyst position is responsible for identifying and...are paid timely. + Extracts correct and accurate financial data from appropriate sources to report and/or seek reimbursement… more
- Humana (Austin, TX)
- … requires an in-depth evaluation of variable factors. The Senior Workforce Management Professional plays a pivotal role in supporting Medicaid Inpatient and ... community and help us put health first** The Senior Workforce Management Professional applies and integrates advanced and predictive analysis, people metrics and … more
- Humana (Austin, TX)
- …model designs including analyzing provider performance, reporting , and scorecard/reconciliation reporting . + Understanding of Medicaid and/or Medicaid ... first** Humana Healthy Horizons is seeking a Senior Value-Based Programs professional who will support successful value-based provider relationships with a focus… more
- Humana (Austin, TX)
- …our caring community and help us put health first** The Senior Agency Management Professional provides support for handling and analyzing data that pertains to ... determination of the appropriate courses of action. The Senior Agency Management Professional provides support for handling and analyzing data that pertains… more
- Humana (Austin, TX)
- …caring community and help us put health first** The Workforce Management Professional 2 applies and integrates advanced and predictive analysis, people metrics and ... reporting to develop strategic and operational insights for workforce...management, diversity and human resource compliance). The Workforce Management Professional 2 work assignments are varied and frequently require… more
- Humana (Austin, TX)
- …and help us put health first** The IHWA Follow-up Senior Program Delivery Professional provides daily operational support to programs that impact members' lives by ... promoting preventive health activities. The IHWA Follow-up Senior Program Delivery Professional works on problems of diverse scope and complexity ranging from… more
- Molina Healthcare (Austin, TX)
- …coordination, and shared ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** ... Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits,… more
- Molina Healthcare (Houston, TX)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid /Medicare/Marketplace health coverage audit policies and be able to apply them in ... abuse, and over utilization by providers and recipients. The position will review claims data , medical records, and billing data from all types of healthcare… more
- Apex Health Solutions (Houston, TX)
- …of the organization, ensuring accuracy, compliance, and integrity in financial reporting . This role requires a licensed Certified Public Accountant (CPA) with ... premium revenue, claims reserves, medical loss ratio analysis, and regulatory reporting . The Controller partners closely with executive leadership to drive strategic… more
- Houston Methodist (Katy, TX)
- …meetings, resources and equipment, to ensure staff competency and professional pathway progression. + Communicates updates/changes to processes, managed care ... systems to enhance operations; supports entity-specific performance improvement and data management/analysis functions. + Employs a proactive approach in the… more
- Houston Methodist (Houston, TX)
- … for hospital-based statistics and regulatory agencies such as OPTN/UNOS/CMS and Medicaid to ensure compliance with all governmental reporting requirements, and ... practice. The Post-Transplant Coordinator position interacts with all members of inter- professional transplant team to ensure coordination of care for the… more
- Humana (Austin, TX)
- …ranging from moderate to substantial. The Actuary, Analytics/Forecasting supports centralized reporting of external data sharing, oversees internal reporting ... The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and… more
- Houston Methodist (Houston, TX)
- …all transplant team members, patients, referring physicians, and other health care providers, reporting pertinent patient care and family data in a comprehensive ... statistics and regulatory agencies, if applicable, such as OPTN/UNOS/CMS/NMDP/CIBMTR/FACT, and Medicaid to ensure compliance with all government reporting … more