- Molina Healthcare (Fort Worth, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting,… more
- Zelis (Plano, TX)
- …interests that shape who you are. Position Overview The Sr. Medicaid Reimbursement Regulatory Analyst will collaborate with the Zelis Regulatory Pricer ... an accurate and timely fashion. What you'll do: + Research and decipher regulatory sources such as legislative rules, state registers, waiver programs and bulletins… more
- Molina Healthcare (TX)
- **Job Description** **Job Summary** We are seeking a highly experienced Lead Analyst , Configuration Oversight to support our Payment Integrity and Claims ... identify and troubleshoot claim discrepancies by utilizing benefit and provider contracts, regulatory requirements and various claims related resources + Strong… more
- CVS Health (Austin, TX)
- …care and how provider reimbursement policies relate to the control of medical claims costs. + Full comprehension of provider contracts and the potential impact the ... regulatory /legislative environment has on reimbursement strategies. + An understanding...differentiating between inpatient and outpatient services, facility and professional claims , and impacts from population dynamics. + Underwriting, sales,… more
- Highmark Health (Austin, TX)
- …MUST 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… more
- US LawShield (Houston, TX)
- …2 million people in their self-defense journey. US LawShield is seeking a Senior Data Analyst to join our data and analytics team. This role will be pivotal in ... similar platforms. + Conduct in-depth analyses of member engagement, retention, claims , and operational performance to identify trends, risks, and opportunities. +… more
- Prime Therapeutics (Austin, TX)
- …decision we make. **Job Posting Title** Sr. Applied Stars and Quality Analytics Analyst - Remote **Job Description** The Senior Health Data Analyst provides ... programs that align with Prime's strategic imperatives and will lead high-complexity analysis and special projects as required. **Responsibilities** +… more
- CVS Health (Irving, TX)
- …to join our PBM Customer Reporting group as a Senior Reporting Analyst within our Compliance Pharmacy Payments. CVS Health strives to continuously innovate ... work with a collaborative, close-knit team on pharmacy and member specific claims data including, but not limited to, financial and operational information… more
- Halliburton (Houston, TX)
- Benefits Operations Analyst - Global Programs Date: Jul 5, 2025 Location: Houston, TX, US, 77032 We are looking for the right people - people who want to innovate, ... achieve, grow and lead . We attract and retain the best talent by...inquiries + Assist in the implementations of new vendors, regulatory changes and/or plan design changes + Support RFP… more
- Brown-Forman (Dallas, TX)
- …and a drive to make a global impact? Join Brown-Forman and take the lead in optimizing our insurance programs. This isn't just about managing policies; it's about ... and Partnership:_ Ensure our global insurance programs consistently comply with local regulatory and tax requirements across our international footprint. You'll be a… more
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