- Molina Healthcare (Houston, TX)
- …to the Health Care environment. **Knowledge/Skills/Abilities** The Operational/Regulatory Oversight Analyst works with health plans and operations departments to ... to and compliance with State and Federal regulatory guidelines. The Analyst develops and performs audits and oversight functions involving business-critical… more
- Molina Healthcare (Austin, TX)
- …business analysis, task and workflow analysis. + Subject matter expert of Medicare and Healthcare enrollment 834 files. + Interpret customer business needs and ... translate them into application and operational requirements + Communicate and collaborate with external and internal customers to analyze and transform needs, goals and transforming in to functional requirements and delivering the appropriate artifacts as… more
- Molina Healthcare (Houston, 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. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment… more
- 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
- Humana (Austin, TX)
- …of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting work assignments are varied and frequently require… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Senior (Sr.) Accountng and Reporting Analyst position is responsible for identifying and compiling information to effectively report costs ... reimbursement from various government programs. The Sr. Accounting and Reporting Analyst utilizes strong data analytic skills to identify issues and researches… more
- CVS Health (Irving, TX)
- …TX., Scottsdale, AZ., or Northbrook, IL **Position Summary** As a Senior Financial Analyst , Financial Operations, put your skills to use in a challenging position ... and to grow with our finance operations team. This Senior Financial Analyst , Adjustment Reporting and Research position focuses on claim adjustment reporting; and… more
- Cognizant (Plano, TX)
- **Sr. QNXT Config Analyst .** **About the role:** As a Sr. QNXT Config Analyst , you will make an impact by conducting requirements using QNXT configuration. You ... + Experience with cautionary reduction functionality. + QNXT SMEs with experience in Medicare Benefit. + Experience with items like Cost Share. + Experience with… more
- Molina Healthcare (Dallas, TX)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing… more
- HCA Healthcare (Houston, TX)
- …Do you have the career opportunities as a Revenue Integrity Charge Review Analyst you want with your current employer? We have an exciting opportunity for ... of colleagues. Do you want to work as a Revenue Integrity Charge Review Analyst where your passion for creating positive patient interactions is valued? If you are… more
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