- Molina Healthcare (San Antonio, TX)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating ... advanced SQL queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain efficient ETL pipelines… more
- Sysco (Houston, TX)
- …Greens Crossing Blvd, Houston, TX 77038** **Job Summary:** The Leave of Absence Analyst is responsible for managing employee leave and return to work processes, ... Work:** Review and audit Return to Work process for claims , including Return to Work transitional program, process with...Previous experience in case management, HR, or leave administration preferred . + Strong knowledge of leave laws (FMLA, ADA,… more
- Prime Healthcare (Farmers Branch, TX)
- …Finance, Business Analytics, Healthcare Administration or other healthcare related profession is preferred . + Six Sigma, Lean or similar experience preferred + ... Cycle processes and applications such as billing, coding, reimbursement methodologies, claim denial, etc. + Proficient in business software applications, and related… more
- Highmark Health (Austin, TX)
- …2 years of Coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 1 year of Project leadership in ... a complex, matrixed environment (payer and/or provider preferred ) + 1 year of Providing analytical consultation to clinical, administrative, operational and… more
- OneMain Financial (Fort Worth, TX)
- …structure, role definition and system enhancements. + Process State Disability Claims as necessary. + Participates/drives special projects or assignments as needed. ... tools in order to analyze, reconcile, and present data. ** Preferred :** + Experience in administering a CA VDI Plan...a CA VDI Plan and other state disability offsets preferred . + Prior Workday experience working with leave, payroll… more
- WTW (Dallas, TX)
- …management program design, pharmacy solutions, disability/absence management strategies and claims audit services. Product-based solutions such as our pharmacy ... degree with a minimum overall GPA of 3.0 + Preferred course work may include human capital/human resource management,...Successful completion of one or more actuarial exams highly preferred + Ability to be a self-starter and work… more
- Molina Healthcare (San Antonio, TX)
- …Perform research and analysis of complex healthcare utilization and performance date, claims data, pharmacy data, and lab data regarding utilization and cost ... combination of education and experience **Required Experience** 3-5 years ** Preferred Education** Bachelor's Degree or equivalent combination of education and… more
- CVS Health (Austin, TX)
- …-3-5 years of data interpretation and analysis experience. -Experience with internal claims data and healthcare coding. -Must be able to travel to provide ... testimony if needed. -Advanced experience with Excel. ** Preferred Qualifications** Certified Professional Coder Knowledge of CVS/Aetna's policies and procedures… more
- The Cigna Group (Plano, TX)
- …required. Experience with trend analysis and health care provider contract analysis preferred . + Knowledge of standard medical coding including CPT-IV, ICD-10, DRG, ... of managed care business processes, data, systems, and applications for claims payment, enrollment, benefit design, and utilization management + Strong analytical… more
- Molina Healthcare (TX)
- …+ Data analytics + Familiarity w/SDLC Methodologies: Agile, waterfall, etc. ** PREFERRED EXPERIENCE:** + SQL expertise + Excel expertise + Medicare, Medicaid, ... Marketplace claims expertise **PHYSICAL DEMANDS:** Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed… more