- Providence (TX)
- …best people, we must empower them._** **Providence is calling a Senior Business Analyst - Risk, Liability & Claims who will:** + Be responsible for providing ... analysis to stakeholders on scheduled basis. + Serve as risk/ claims data consultant/subject matter expert. + Be an excellent...improving risk data management and reporting. **Providence welcomes 100% remote work for applicants who reside in one of… more
- Providence (TX)
- …Directors and Officers, Employment Practices, Fiduciary, Property, Cyber, Managed Care, and Auto Claims . The Senior Quality Analyst assists the Claims ... and regulations pertaining to self-insured health care organizations. The Senior Quality Analyst is also responsible for maintaining a claims quality assurance… more
- Prime Therapeutics (Austin, TX)
- …and drives every decision we make. **Job Posting Title** IT Business Systems Analyst - ScriptMed - Remote **Job Description** The IT Business Systems ... (SDLC) methodology employed by Prime and partnering with the business , IT, and other project stakeholders to elicit, define,...of security implications of domain + Experience in Prime claims systems + Proficiency in Visio, Microsoft Word, Excel,… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... and regulatory guidance. The ideal candidate will bring deep knowledge of claims adjudication, QNXT system navigation, and strong analytical acumen. Experience in… more
- Prime Therapeutics (Austin, TX)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description** The Senior Pricing ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and third-party ... potential risk areas and revenue potential. The Sr Compliance Coding Analyst position partners with stakeholders to provide feedback regarding documentation and… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources to identify early signs… more
- Molina Healthcare (San Antonio, TX)
- **Job Description** **Job Summary** The Senior Analyst will serve a key role on the RADV (Risk Adjustment Data Validation) team, contributing to the end-to-end data ... Success in this role requires a blend of strong technical acumen, business context, and analytical curiosity. While data is primarily accessed through Databricks,… 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 ... plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and...for the assigned state + Works in an agile business environment to derive meaningful information out of complex… more