- Molina Healthcare (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 Reporting modules related to Quality/HEDIS for Medicaid , Marketplace and Medicare/MMP. + Analysis and reporting related...and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality… more
- Cognizant (Austin, TX)
- …digital transformation initiatives * Deep understanding of payer functions and Medicaid plan implementations, including enrollment, billing, claims , care ... **Health Payer Business Analyst , Senior Consulting Manager** **About the Role:** As...* Strong background in Healthcare industry, including health plans, claims , and provider operations * Project management and people… more
- Cognizant (Austin, TX)
- **Job Title: Sr. QNXT Configuration Analyst ** **Location:** **Remote** **Job ID:** **00067091141** **About the role** As a **Sr. QNXT Configuration Analyst ** , ... make an impact by configuring and maintaining QNXT systems to ensure accurate claims processing and compliance with client requirements. You will be a valued member… more
- Molina Healthcare (Fort Worth, TX)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, actionable… more
- Molina Healthcare (Dallas, TX)
- …care or payer environment. + In-depth knowledge of medical and hospital claims processing, including CPT/HCPCS, ICD, and modifier usage. + Strong understanding of ... and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). + Medical Coding… more
- CVS Health (Austin, TX)
- …complex data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate ... We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a...in healthcare fraud, waste and abuse + Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory… more