• Medicare Risk Adjustment Advanced…

    Elevance Health (Grand Prairie, TX)
    ** Medicare Risk Adjustment Advanced Analyst Senior** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... and adaptable workplace. Alternate locations may be considered. The ** Medicare Risk Adjustment Advanced Analyst Senior** is...**How you will make an impact:** + Prepares analytical data sets in support of modeling studies. + Build,… more
    Elevance Health (08/16/25)
    - Related Jobs
  • Senior Business Analyst ( Medicare

    Molina Healthcare (Austin, TX)
    **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data (SQL and advanced Excel functions) from internal and external sources to ... Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis… more
    Molina Healthcare (07/27/25)
    - Related Jobs
  • Senior Actuarial Analyst ( Medicare

    Molina Healthcare (Austin, TX)
    **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... Extracts, analyzes, and synthesizes data from various sources to identify risks. Maintain/update SQL model(s), estimate risk scores, and analyze impact.… more
    Molina Healthcare (07/25/25)
    - Related Jobs
  • Healthcare Claims Data Analyst

    Zelis (TX)
    …you are. Position Overview We are seeking a detail-oriented and technically skilled analyst to support healthcare claims repricing and data validation efforts. ... (joins, CTEs, subqueries) to extract, manipulate, and audit claim data . + Evaluate pricing scenarios based on Medicare... data . + Evaluate pricing scenarios based on Medicare , Medicaid, and commercial reimbursement rules. + Apply working… more
    Zelis (08/19/25)
    - Related Jobs
  • Senior Quality Analyst , Claims *Remote

    Providence (TX)
    …Fiduciary, Property, Cyber, Managed Care, and Auto Claims. The Senior Quality Analyst assists the Claims leaders in managing a quality assurance program to ... regulations pertaining to self-insured health care organizations. The Senior Quality Analyst is also responsible for maintaining a claims quality assurance program,… more
    Providence (08/01/25)
    - Related Jobs
  • Sr. Accounting and Reporting Analyst - FT…

    Houston Methodist (Houston, TX)
    …seek maximum reimbursement from various government programs. The Sr. Accounting and Reporting Analyst utilizes strong data analytic skills to identify issues and ... At Houston Methodist, the Senior (Sr.) Accountng and Reporting Analyst position is responsible for identifying and compiling information to effectively report costs… more
    Houston Methodist (06/24/25)
    - Related Jobs
  • Lead Analyst , Payment Integrity

    Molina Healthcare (San Antonio, TX)
    …coordination, and shared ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational ... Provides lead level support as a highly capable business analyst who serves as a key strategic partner in...and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements… more
    Molina Healthcare (08/20/25)
    - Related Jobs
  • Senior Analyst , Healthcare Analytics (Risk…

    Molina Healthcare (Austin, TX)
    …finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + ... **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for...include research, analysis and modeling of complex healthcare claims data , pharmacy data , lab data ,… more
    Molina Healthcare (07/17/25)
    - Related Jobs
  • Risk Adjustment Audit Operations Analyst

    Molina Healthcare (Houston, TX)
    …for medical record collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data , regulatory processes, and ... **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the...or analytics + Exposure to Databricks, Spark, or similar data platforms + Familiarity with Medicare Advantage… more
    Molina Healthcare (08/08/25)
    - Related Jobs
  • Actuarial Analyst 2

    Humana (Austin, TX)
    …and independent determination of the appropriate courses of action. The Actuarial Analyst 2, Analytics/Forecasting ensures data integrity by developing and ... of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data more
    Humana (08/16/25)
    - Related Jobs