• Utilization Management Senior Business…

    Molina Healthcare (Santa Fe, NM)
    **Knowledge/Skills/Abilities** + Perform research and analysis of complex healthcare utilization and performance date, claims data, pharmacy data, and lab data ... utilization and cost containment information. + Evaluate, write, and present healthcare utilization and cost containment reports and makes recommendations based on… more
    Molina Healthcare (08/02/25)
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  • Senior Analyst , Healthcare

    Evolent (Harrisburg, PA)
    …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** ** Senior Analyst , Healthcare Analytics Consultant** The Client Analytics team ... our specialty programs and administrative platform. **Role Overview** The Senior Analyst role on Client Analytics will...Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify… more
    Evolent (07/31/25)
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  • Senior Analyst , Medical Economics…

    Molina Healthcare (Columbus, OH)
    **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms… more
    Molina Healthcare (07/10/25)
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  • HC & Insurance Operations Processing Sr Rep

    NTT America, Inc. (Plano, TX)
    …methodology/ fee schedule **Required Skills/Experience** + 1+ years hands-on experience in Healthcare Claims Processing + 2+ years using a computer with ... as part of an overall sourcing strategy. NTT DATA currently seeks a ** Claims Processing Associate** to join our team for a remote position. **Role Responsibilities**… more
    NTT America, Inc. (08/03/25)
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  • Senior Analyst , Risk & Quality…

    Molina Healthcare (ID)
    **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... plan reports related to managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates + Assists and...position, please apply through the intranet job listing Molina Healthcare offers a competitive benefits and compensation package Molina… more
    Molina Healthcare (05/31/25)
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  • Senior Healthcare Data…

    Staffing Solutions Organization (Albany, NY)
    …workforce, which is a reflection of our clients and the people they serve. ** Senior Healthcare Data Analyst ** **(Location - Albany, NY)** **Summary:** The ... and business context of various elements related to Medicaid claims . Related efforts will include the production of reports...reports in support of the intake and management of healthcare data. The ideal candidate will be able to… more
    Staffing Solutions Organization (07/10/25)
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  • Sr Product Owner

    Evolent (Carson City, NV)
    …You'll Need (Required):** + Bachelor's Degree + 2+ years' experience in healthcare , IT business analyst , and/or product management + Experience working ... You'll Be Doing:** Evolent Health is looking for a Senior Product Owner to be a key member of...+ Microsoft Office experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration,… more
    Evolent (07/09/25)
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  • Senior Analyst , Risk Adjustment…

    Molina Healthcare (Buffalo, NY)
    **Job Description** **Job Summary** The Senior Analyst will serve a key role on the RADV (Risk Adjustment Data Validation) team, contributing to the end-to-end ... equivalent discipline **Required Experience** + 3-5 Years of experience with healthcare -related data ( claims /encounters, provider, CMS/EDGE response files, etc.… more
    Molina Healthcare (08/03/25)
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  • Senior Compliance Coding Analyst

    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
    Houston Methodist (05/30/25)
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  • Senior Provider Audit Analyst

    Point32Health (Canton, MA)
    …members, partners, colleagues and communities. **Job Summary** The Sr Provider Audit Analyst is responsible for review of claims for accuracy of coding, ... (minimum years required): + Required (minimum): 5-7 years of related professional healthcare experience including familiarity with medical claims processing. +… more
    Point32Health (07/18/25)
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