- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and ... potential risk areas and revenue potential. The Sr Compliance Coding Analyst position partners with stakeholders to provide feedback regarding documentation and… more
- Elevance Health (Grand Prairie, TX)
- **Business Information Analyst Senior - Medicaid Encounters Data** The **Business Information Analyst Senior** is responsible for analyzing and validating ... healthcare encounter data submissions to CMS (Centers for Medicare & Medicaid Services). This role involves ensuring the accuracy and completeness of data,… more
- Prime Therapeutics (Austin, TX)
- …and drives every decision we make. **Job Posting Title** Sr. Compliance Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Analyst assists in the implementation of Prime's compliance programs,...organization, or other highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +… more
- Centene Corporation (Austin, TX)
- …Opportunity**_** **_The ideal candidate will have:_** + **_Deep knowledge of the Medicare Advantage program, with hands-on experience in Dual Eligible Special Needs ... for its Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to… more
- CenterWell (Austin, TX)
- …and procedures. Humana is seeking an experienced Informaticist 2 / Data Analyst to support its medication adherence initiatives. This role is responsible for ... generate reports, and present actionable insights to support key initiatives-including Medicare and Medicaid programs, trend management efforts, and other strategic… more
- CVS Health (Austin, TX)
- …we do it all with heart, each and every day. **Position Summary** The Analyst is responsible for ensuring the CAS and NLX prior authorization application are working ... IT Terminology + 3+ years of experience working with Commercial and Medicare clients in the CAS and NLX prior authorization applications. **Preferred… 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 ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Baylor Scott & White Health (Temple, TX)
- **Job Description :** We are seeking a detail-oriented and experienced **System Analyst 2** to join our team. The ideal candidate will be responsible for testing, ... documentation and communication skills. **Preferred Skills:** + Experience with **Medicaid/ Medicare ** claims processing. + Familiarity with **Agile/Scrum** methodologies. +… more
- CVS Health (Austin, TX)
- …data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to regulators, including ... internal and external stakeholders **Preferred Qualifications** * Medicaid and/or Medicare managed care experience **Education** * Master's degree or equivalent… more
- Molina Healthcare (Dallas, TX)
- …and set up complicated proof of concept tests without needing mentoring + Eg, Medicare Exclusion POC + Acts as a team lead, assigning and prioritizing work for ... other team members as needed. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent combination of education and experience **Required Experience** 5-6 Years **Preferred Education** Graduate Degree or equivalent experience **Preferred… more