- Wolters Kluwer (Austin, TX)
- …Location:_** Riverwoods, IL (USA) **About the Role:** We are seeking a highly skilled Business Analyst to join the Mediregs team focusing on claims ... contribute to software maintenance and final acceptance testing. The Business Analyst works closely with a cross-functional...tools (eg, SQL, Excel, Tableau). + Recent experience with healthcare claims software (eg, Epic, Cerner, or… more
- Molina Healthcare (Austin, TX)
- …cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health Plans ... is a general role in which employees work with multiple types of business data. Will work cross functionally across multiple business areas.… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization ... numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc. + Analysis and forecasting of trends in… more
- Molina Healthcare (Austin, TX)
- …self-navigate organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to ... **Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the… more
- Molina Healthcare (Austin, TX)
- … healthcare operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.) + Knowledge of healthcare financial terms ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to...the Health Plan and Finance team through analyzing key business issues related to cost, utilization and revenue for… more
- Evolent (Austin, TX)
- …reimbursement structures associated with Commercial, Medicare, and Medicaid lines of business . Healthcare claims : specifically, differences between ... **Required** + 2+ years of SAS, SQL Programming Experience with large amounts of healthcare claims and authorization data - **Required** + 2+ years of experience… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Analyzes complex business problems and issues using data from internal and external sources to provide insight to ... influences. Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and… more
- Molina Healthcare (Austin, TX)
- …both verbally and written. + You can prioritize. + You have experience with QNXT, claims processing , healthcare insurance and SQL + You pay attention to ... Description** Who you are : + You have proven experience as a QA Analyst within an Agile environment. + Experienced testing on-premise and cloud based ETL/BI… more
- Molina Healthcare (Austin, TX)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...+ Must have experience in system configuration. + Monitor claims , create , generate and analyze reports using Excel… more
- Molina Healthcare (Austin, TX)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...and existing health plans. + Must have experience on claims processing system, benefit configuration. + SQL knowledge is… more
- Molina Healthcare (Austin, TX)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
- Molina Healthcare (Austin, TX)
- **Job Description** **Job Summary** The Analyst , Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and ... and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality...overall markets and LOB. + Work in an agile business environment to derive meaningful information out of complex… more
- Evolent (Austin, TX)
- …Excel, SAS, SQL, or similar analytical software to analyze clinical authorization and healthcare claims data + Using analytical tools to integrate various data ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...SQL or SAS is preferred + 2-5 years of healthcare -related experience is preferred **Technical Requirements:** We require that… more
- Molina Healthcare (Austin, TX)
- …used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables ... departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods… more
- Prime Therapeutics (Austin, TX)
- …analysis to include 1 year of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Must be eligible to ... our passion and drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides… more
- Sumitomo Pharma (Austin, TX)
- …and to clean up historical utilization that is routinely submitted with Medicaid claims . In addition, the analyst will load Medicaid claim information into ... dynamic, highly motivated, and experienced individual for the position of ** Analyst , Medicaid Rebates.** This individual contributor role is responsible for… more
- Prime Therapeutics (Austin, TX)
- …complex queries to include 3 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare , and/or related field + Must be eligible to ... every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The...revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other… more
- Evolent (Austin, TX)
- …Experience You'll Need (Required):** + Bachelor's Degree + 2+ years' experience in healthcare , Operations, IT business analyst , and/or product management + ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...+ Microsoft Office experience (Excel, Visio) + Understanding of healthcare data formats (eg, eligibility, claims , configuration,… more
- Prime Therapeutics (Austin, TX)
- …Reporting Analyst - Remote **Job Description** The Senior Data & Reporting Analyst is responsible for supporting the business in decision making and ... operations efforts by providing data, reporting and business intelligence services. This role is responsible for acting...experience + PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or… more