- USAA (Plano, TX)
- …all things Service to better serve USAA's members. They will closely collaborate with Claims leaders and business partners to deliver on Claims commitments ... position will be joining the Service Team within the Claims Actuary and Analytic community, which is part of...and deliverables** . Provide decision support for business areas across the enterprise. Staff in this area… more
- Molina Healthcare (San Antonio, TX)
- …pertaining to the Health Care environment **Job Duties** The Operational/Regulatory Oversight Sr . Analyst works with health plans and operations departments to ... of applicable laws and regulations, which will protect the Business from liability and potential risk. Ensures that the...and compliance with State and Federal regulatory guidelines. The Sr . Analyst develops and performs audits and… more
- 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 ... compliance reviews and identifying potential risk areas and revenue potential. The Sr Compliance Coding Analyst position partners with stakeholders to provide… more
- Elevance Health (Grand Prairie, TX)
- ** Business Information Analyst Senior - Medicaid Encounters Data** The ** Business Information Analyst Senior ** is responsible for analyzing and ... and other regulatory reporting requirements. + Develop and analyze business performance reports (eg, for claims data,...and analyze business performance reports (eg, for claims data, provider data, utilization data) and provides notations… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** This Sr . Analyst , Healthcare Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment ... team. Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data… more
- Molina Healthcare (Houston, TX)
- **JOB DESCRIPTION** **Job Summary** This Sr . Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... skills in data analysis. Performs research and deep-dive analysis of complex healthcare claims data, CMS return files, and financial cost, revenue, and vendor data.… more
- Citigroup (San Antonio, TX)
- The Fraud Ops Sr Analyst is a senior level positions responsible for contributing to the development of fraud management policies, processes and procedures ... and train new recruits + Appropriately assess risk when business decisions are made, demonstrating particular consideration for the...of experience in a related role + Intermediate to senior level experience in a similar position preferred +… more
- Highmark Health (Austin, TX)
- …BE A US CITIZEN This position serves as a key liaison between Claims Operations, Customer Service, Regulatory Affairs, IT, Legal and other departments, proactively ... identifying, assessing, and mitigating compliance risks. The Analyst will monitor regulatory changes, interpret their impact on operational processes, and implement… more
- Molina Healthcare (San Antonio, TX)
- **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr . Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by ... translating healthcare business needs into technical solutions. This role works closely...queries to extract, validate, and analyze healthcare data, including claims , pharmacy, and lab datasets. + Build and maintain… more
- Prime Therapeutics (Austin, TX)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Pricing Analyst Senior - Remote **Job Description** The Senior Pricing ... 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