- Molina Healthcare (Fort Worth, TX)
- …accurate and timely implementation and maintenance of critical information on all claims and provider databases, validate data housed on databases and ensure ... oversight to ensure that the contracts are configured correctly in QNXT. The claims are reviewed to ensure that the configured services are correct. Maintain the… more
- Molina Healthcare (Dallas, TX)
- …for accurate and timely implementation and oversight of critical information on claims databases. Synchronizes data among operational and claims systems and ... primary responsibility and focus will be related to the Texas Medicaid Directed Payment Program (DPP). **KNOWLEDGE/SKILLS/ABILITIES** + Analyze and interpret data… more
- Molina Healthcare (San Antonio, TX)
- …Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan financial ... and executing operational initiatives tied to Payment Integrity (PI) and provider claims accuracy. The individual will be relied upon to make independent, informed… more
- Prime Therapeutics (Austin, TX)
- …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... passion and drives every decision we make. **Job Posting Title** Sr. AI Business Analyst - Remote **Job Description** **Are you a Business Systems Analyst with… more
- Baylor Scott & White Health (Austin, TX)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position analyzes ... and outbound encounter process. + Monitors and oversees the end-to-end claims encounter management workflow. + Identifies and interprets encounter data, submission… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... and manage information from large data sources. + Analyze claims and other data sources to identify early signs...performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina… more
- Molina Healthcare (Fort Worth, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... Hospital payment methodology & processing is essential + Understanding on hospital claims processing and configuration works + Medicare fee schedule knowledge is… more
- Molina Healthcare (Austin, TX)
- **Job Summary** The Lead Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team. Designs and develops reporting ... health plan reports related to Risk and Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP * Develops custom health plan...plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates * Assists and… more
- Molina Healthcare (Austin, TX)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... as well as automated analytical Reporting modules related to Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. + Analysis and reporting related to Managed… more
- Molina Healthcare (San Antonio, TX)
- …prioritize work to meet deadlines and needs of user community. + GA Medicaid claims / reimbursement/ coding experience is highly preferred **JOB QUALIFICATIONS** ... accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes… more