- Houston Methodist (Houston, TX)
- …**GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Seeks out opportunities to grow knowledge of Medicare reimbursement , tax regulations, State 1115 waivers, FEMA, and ... service focus and application of positive language principles + Expert knowledge of Medicare reimbursement , tax and/or FEMA rules preferred + Strong knowledge of… more
- Molina Healthcare (Fort Worth, 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 shared ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** + Assists… more
- Zelis (Plano, TX)
- …analysis, and reporting. + Understand claim payment methodologies such as Medicare , Medicaid, and Commercial Reimbursement . + Create visualizations and ... years of experience in healthcare data analysis. + 1+ years in claim reimbursement methodologies ( Medicare , Medicaid, Commercial) + Experience with Tableau is a… more
- Zelis (Plano, TX)
- …reimbursement , claim payment or cost reporting. + Experience with Medicare / Medicare Advantage or commercial billing and reimbursement a plus + Ability to ... that shape who you are. Position Overview The Sr. Medicaid Regulatory Pricer Analyst will collaborate with the Zelis Regulatory Pricer Product team to further the… 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 ... expert on developing financial models to evaluate the impact of provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical… 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,...resolve regulatory inquiries/complaints related to claims, contracting and pharmacy reimbursement . Works directly with business partners across the enterprise.… more
- Molina Healthcare (Dallas, TX)
- …coordination, and ownership of high-value deliverables-distinct from a pure data analyst role. **Job Duties** **Business Leadership & Operational Ownership** + ... of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape recommendations and action plans. +...At least 7 years of experience as a Business Analyst or Program Manager in a Managed Care Organization… more
- Banner Health (TX)
- …information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or ... and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health… more
- HCA Healthcare (Dallas, TX)
- …Develop a financial infrastructure that ensures efficiency, optimizes cost capture for Medicare Cost Reports, and improves reimbursement strategies. + Work with ... Institute (Kidney, Liver, Pancreas and Heart). + Work with division analyst to evaluate competitive market trends and opportunities. **Operational & Financial… more