• Senior Reporting Analyst

    CVS Health (Austin, TX)
    …Trifacta, Linux OS, GCP/ AWS/ Azure. + Experience working with medical and/or pharmacy claims data. + Experience in healthcare industry, including health ... to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy ...You will work with a collaborative, close-knit team on pharmacy and member specific claims data including,… more
    CVS Health (08/16/25)
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  • Investigator Senior

    Elevance Health (Grand Prairie, TX)
    …referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims . + Responsible for independently identifying ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
    Elevance Health (08/13/25)
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  • Senior Analyst, Special Investigative Unit

    CVS Health (Austin, TX)
    …each and every day. **Position Summary** We are seeking an experienced Senior Healthcare Fraud Investigator to join our Dental/ Pharmacy /Broker Investigative Team ... abuse. + Conduct Investigations to prevent payment of suspect or fraudulent claims submitted by insured's, providers, claimants and customers. + Researches and… more
    CVS Health (08/24/25)
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  • Senior Analyst, Product Implementation

    CVS Health (Austin, TX)
    …enterprise operations teams using a variety of platforms. We service medical, pharmacy , sales, product and call center support models across the CVS enterprise. ... in project execution. **Required Qualifications** + 5 or more years of related professional experience + 3 or more years of working directly with SQL database… more
    CVS Health (08/21/25)
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  • Senior Project Manager - Building Group

    Royal Electric (Dallas, TX)
    …documentation including but not limited to submittals, RFI's, delay notices, potential claims , and extended overheads. + Maximize cash flow by balancing project cost ... Dependent care (Daycare children & elderly - work related), & Transit + Pharmacy discounts + Kisx Card (Surgery & Imaging Program) + Opportunity for tuition… more
    Royal Electric (08/21/25)
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  • Ld Dir, PBM Underwriting

    CVS Health (Austin, TX)
    …of PBM profit levers, underwriting and financial models. + Understanding of healthcare and pharmacy claims data and common tools used to manipulate data. + ... opportunity to join it's CVS Health's leadership team as a Director, Pharmacy Benefit Management (PBM) Underwriting, Analysis and Strategy. In this role, you… more
    CVS Health (08/09/25)
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  • Early Careers: Intern Conversion Only - Health…

    WTW (Dallas, TX)
    …specialty consulting services including clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims ... all try to have some fun! + Exposure to Senior leadership and thought leaders across the firm At...etc. + Gain specialized knowledge in areas such as pharmacy , life and disability insurance, health equity and wellbeing,… more
    WTW (08/15/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Austin, TX)
    …with business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, ... or data requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional , you will develop and/or evaluate compliance… more
    Humana (08/23/25)
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  • Sr. Compliance Analyst - Remote

    Prime Therapeutics (Austin, TX)
    …internal stakeholders to research and resolve regulatory inquiries/complaints related to claims , contracting and pharmacy reimbursement. Works directly with ... Analyst - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance Analyst assists in the implementation of Prime's compliance programs,… more
    Prime Therapeutics (08/14/25)
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  • Branch Coordinator, Home Health

    CenterWell (Mineral Wells, TX)
    …team at the branch to ensure other billing requirements are satisfied to release claims timely. + Adhere to and participate in Agency's mandatory HIPAA / Privacy ... Guidelines. + Managing all incoming telephone calls in a professional manner including: + Screen and route calls to...at the center. As the nation's largest provider of senior -focused primary care, one of the largest providers of… more
    CenterWell (08/08/25)
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