• Senior Quality Analyst,…

    Providence (TX)
    …Directors and Officers, Employment Practices, Fiduciary, Property, Cyber, Managed Care, and Auto Claims . The Senior Quality Analyst assists the Claims ... claims environment, and respond positively to change.** **The Senior Quality Analyst performs all duties in...and propose opportunity solutions and success replication. Propose monthly audit focus topics to claims leaders based… more
    Providence (08/01/25)
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  • Senior Compliance Coding Analyst…

    Houston Methodist (Houston, TX)
    …risk and identify and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of ... specific practices. Serves a subject matter expert. + Effectively communicates audit results to faculty and staff. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS**… more
    Houston Methodist (05/30/25)
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  • Data Management Strategy & Governance…

    The Cigna Group (Plano, TX)
    …and data informatics and data exchange using healthcare and clinical data such as Claims , Membership, Audit , Client Structure, and Benefits. If you will be ... job profile for this position is Data Management Strategy Senior Advisor, which is a Band 4 Senior...system analysis, and data retention processes to assure data quality standards. + Collaborate with other departments to ensure… more
    The Cigna Group (07/30/25)
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  • Senior Reporting Analyst

    CVS Health (Irving, TX)
    …an exciting opportunity to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to ... a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and...reporting using SQL and SAS. You will continuously improve quality controls and accuracy of reported data, looking for… more
    CVS Health (07/09/25)
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  • Senior Facility Manager

    Cushman & Wakefield (Austin, TX)
    **Job Title** Senior Facility Manager **Job Description Summary** This position has managerial oversight of multiple facilities, an entire campus, or a portfolio of ... Facilities Manager and/or Assistant Facilities Manager reporting into it. The Senior Facilities Manager has the overall responsibility for overseeing the… more
    Cushman & Wakefield (07/16/25)
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  • Field Quality Manager

    AUI Partners (TX)
    …action. Oversee and assist in the management of mitigating and resolving potential claims . Assist in reviewing Plans do quality review of drawings when ... measures when necessary and recommend action. Prepare and present reports on quality performance, trends, and improvement initiatives to senior management.… more
    AUI Partners (08/01/25)
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  • Director, Operational Oversight (Medicare/Duals)…

    Molina Healthcare (Fort Worth, TX)
    …and you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer ... grievances, and member communications. * Exposure to downstream domains: Enrollment, Claims , Pharmacy/PDE, Network, Stars quality metrics. * Proven record… more
    Molina Healthcare (07/13/25)
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  • Mgr Compliance Monitoring & Auditing

    ManpowerGroup (Houston, TX)
    …with the Compliance Program, and with HHSC, TDI, NCQA and Health Plan Senior Management. * Ensure ongoing compliance with federal and state regulations and provide ... Health Plan in developing an auditing and monitoring program. Develop comprehensive audit tools to objectively measure internal performance and performance of third… more
    ManpowerGroup (06/14/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently operates about ... 340+ senior focused primary care centers in 15 states. The...that supports the PCO is responsibility to assess, investigate, audit and validate the mitigation of compliance risk across… more
    Humana (07/29/25)
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  • Home Mortgage Loss Mitigation Back End Manager

    Citizens (Irving, TX)
    …and Home Equity products. Working closely with Loss Mitigation strategies, senior management, Product Owners and support teams, you will drive industry-leading ... department and takes ownership for producing high volume and high- quality work while adhering to investor and regulatory guidelines....progress + Prepares and presents workflow and results to Senior Management and clients as needed + Assists in… more
    Citizens (07/30/25)
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