- Elevance Health (Grand Prairie, TX)
- …not eligible for employment based sponsorship. **Ensures accurate adjudication of claims , by translating medical policies, reimbursement policies, and clinical ... into effective and accurate reimbursement criteria.** PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management, CPT, HCPCS… more
- Cayuse Holdings (Austin, TX)
- **Overview** **_JOB TITLE:_** Business Analyst /Product Owner **_CAYUSE COMPANY:_** Cayuse Civil Services, LLC **_LOCATION_** Austin, TX **_SALARY:_** $108,888.03 - ... to be considered for similar upcoming roles** The Business Analyst /Product Owner will perform work on the PEMS project...Medicaid systems and processes. + 8 years' experience in claims processing. + Must be able to pass a… more
- Evolent (Austin, TX)
- …for the mission. Stay for the culture. **What You'll Be Doing:** **Lead Analyst , Performance Analytics - Oncology & Member Product Focus** **Overview:** Evolent is ... seeking an experienced and strategic **Lead Analyst , Performance Analytics** to lead data-driven initiatives focused on oncology and member-centric products. This… more
- Elevance Health (Grand Prairie, TX)
- **Cost of Care/Provider Contracting Data Analyst ** **Location** : This role requires associates to be in-office 1-2 days per week, fostering collaboration and ... is granted as required by law. The **Cost of Care/Provider Contracting Data Analyst ** is responsible for provides analytical support to the Cost of Care and/or… more
- Bank of America (Plano, TX)
- Fraud Analytics and Innovation Lead Analyst - Fraud Strategy Jacksonville, Florida;Plano, Texas; Richmond, Virginia; Sun City West, Arizona; Boston, Massachusetts; ... must be at least 18 years of age.** Acknowledge (https://ghr.wd1.myworkdayjobs.com/Lateral-US/job/Jacksonville/Fraud-Analytics-and-Innovation-Lead- Analyst Fraud-Strategy\_25042825-2) **Job Description:** At Bank of America, we… more
- Zions Bancorporation (Houston, TX)
- …topics and mindset to actively challenge inputs (eg vendor and business claims ). + Contribute to and lead internal initiatives, including methodology enhancements ... knowledge of word processing, database and spreadsheet software and applications. **_Benefits:_** + Medical , Dental and Vision Insurance - START DAY ONE! + Life and… more
- Humana (Austin, TX)
- …and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral ... closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid… more
- Sedgwick (Fort Worth, TX)
- …Workplaces in Financial Services & Insurance Workforce Analytics & Productivity Monitoring Analyst **PRIMARY PURPOSE OF THE ROLE:** To manage the implementation of ... growth opportunities. + A diverse and comprehensive benefits offering including medical , dental vision, 401k, PTO and more. \#IT \#informationtechnology Work… more
- CVS Health (Austin, TX)
- …Summary** The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning ... the negotiation role, and understanding (U&C) calculated rates and benchmarking of medical costs. The individual will be developing their role as a negotiator,… more
- Molina Healthcare (Austin, TX)
- …and Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department ... **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will...rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and… more