• Senior Clinical & Population Health…

    Highmark Health (Austin, TX)
    …5 years with coding languages, analytical software, systems, tools and processes using claims , clinical, enrollment and provider data + 3 years of project leadership ... in a complex, matrixed environment (payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + None **LICENSES or CERTIFICATIONS** **Required** + None… more
    Highmark Health (07/22/25)
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  • IT Business Systems Analyst Sr - Medicaid…

    Prime Therapeutics (Austin, TX)
    …to determine work assignments within project + Educate and advance business systems analyst practice within the Claims IT team and across the organization ... decision we make. **Job Posting Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job...project team and various levels of management. With consistent Senior Leadership visibility, the IT BSA Sr is also… more
    Prime Therapeutics (08/27/25)
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  • Sr Risk & Insurance Analyst - Workers…

    Rush Enterprises (New Braunfels, TX)
    The Senior Risk and Insurance Analyst - Workers' Compensation serves as the central point of contact for the day-to-day administration of the Workers' ... time and return-to-work program. + Provide strategic guidance on claims progression, settlement strategy, settlement negotiation and authorization, subrogation, and… more
    Rush Enterprises (07/26/25)
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  • Analyst - Insurance Risk

    Toyota (Plano, TX)
    …within the Compliance & Audit seeks a passionate and highly motivated **Insurance Risk Analyst ** . Reporting to the Senior Risk Manager, the person in this ... responsibility of this role is to assist the Insurance Risk Manager(s) and Senior Risk Manager in the various insurance programs for the North American region,… more
    Toyota (08/20/25)
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  • Claims Investigator

    Allied Solutions (Plano, TX)
    …applicability of insurance coverage to certain claim types prior to the assignment to a Claims Adjuster or Analyst . The key responsibilities of this job are both ... is responsible for the initial setup and investigation of claims prior to the assignment of the claim to...Total Losses ; refer timely and accurately to more senior level adjusting staff for adjudication and collection; +… more
    Allied Solutions (07/13/25)
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  • Sr. Configuration Analyst

    NTT America, Inc. (Houston, TX)
    …and forward-thinking organization, apply now. We are currently seeking a Sr. Configuration Analyst to join our team in Houston, Texas (US-TX), United States (US). ... here. NTT DATA, Inc. currently seeks a "TEMP BPO Senior Specialist **"** to join our team. **Client's business...requirement and according to defined business rules of new claims processing platform. + Evaluation of Configuration Requirement and… more
    NTT America, Inc. (08/29/25)
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  • Pricing Analyst Sr - Strong SQL/GCP…

    Prime Therapeutics (Austin, TX)
    …Pricing Analyst Sr - Strong SQL/GCP - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of value generated by Prime's ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
    Prime Therapeutics (08/01/25)
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  • Medicaid Provider Hospital Reimbursement…

    Humana (Austin, TX)
    …community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be ... it expands to accommodate the increased responsibilities. **Responsibilities:** The Senior Business Intelligence Engineer will be primarily responsible for… more
    Humana (08/14/25)
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  • Sr. Medical Analyst

    Norstella (Austin, TX)
    …therapies to market faster and support patients in need. We are seeking a Senior Medical Analyst to join our team and drive data-driven healthcare initiatives. ... Sr. Medical Analyst Company: MMIT Location: Remote, United States Date...extract meaningful insights from real-world data (RWD) sources, including claims , laboratory results, billing codes, and electronic health records… more
    Norstella (07/31/25)
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  • Risk Adjustment Audit Operations Analyst

    Molina Healthcare (Houston, TX)
    **Job Description** **Job Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of ... medical record collection. This is an ideal opportunity for an early-career analyst with a strong interest in healthcare data, regulatory processes, and… more
    Molina Healthcare (08/08/25)
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