- Public Consulting Group (Austin, TX)
- …Project and Grants Management + Assessments and Feasibility Studies Analyzes claims for accuracy, provides client support, documents inquiries, supervises staff, ... process improvements. **Duties and Responsibilities** + Analyzes and reviews claims for accuracy, completeness and eligibility. + Provides leadership, supervision… more
- Microsoft Corporation (San Antonio, TX)
- The **Senior Construction Claims Analyst ** shall work seamlessly with the Global and Regional Claims Lead to play a pivotal role in monitoring and ... Claims and works seamlessly with the Regional Claims Lead to align with GSC execution,...We are currently looking to hire a Senior Construction Claims Analyst for the AMER region, who… more
- Healthfirst (TX)
- **Duties & Responsibilities** : + Lead and deliver projects related to the development and configuration of new business, member benefits and products, claims ... enhancements. + Follow the annual product development processes to manage major claims configuration projects, including claims business rule set up outlier… more
- HomeSafe Alliance (Houston, TX)
- **Title:** Lead IT International Household Goods Movement Analyst (Product Owner) **_HomeSafe Alliance_** is the single global household goods movement manager ... + Coordinate release planning with operations, customer care, supply chain, claims , and other departments. **Customer** **Feedback and Continuous Improvement:** +… more
- Molina Healthcare (Austin, TX)
- …accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes ... completion dates with Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and configuration of all… more
- Kelsey-Seybold Clinic (Houston, TX)
- …of statistical reports (monthly, quarterly, and annually). Provide Resolute to Tapestry claims support. Lead COB/Recovery tasks including analysis and reporting ... **Responsibilities** Responsible for the supervision of Commercial claims adjudication. Essential job functions include ensure that quality and productivity… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings. **KNOWLEDGE/SKILLS/ABILITIES** + Develops, implements, and uses software and systems to… more
- Prime Therapeutics (Austin, TX)
- …passion and drives every decision we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst ... of new or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic… more
- Molina Healthcare (San Antonio, TX)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify...Python, R, etc.) to answer a given problem + Lead monthly trend presentations to plan leadership and other… more
- Cotton Holdings (Houston, TX)
- **Legal Risk Analyst ** **Department:** Legal/Risk **Employment Type:** Full Time **Location:** Houston, TX **Compensation:** $65,000 - $70,000 / year **Description** ... success through innovative risk management strategies. As a **Risk Analyst ** , you'll play a vital role in ensuring...vendors and subcontractors. + **Certificates of Insurance Program** : Lead and maintain the certificates of insurance program for… more
- Prime Healthcare (Farmers Branch, TX)
- …As the Subject Matter Expert (SME) for Revenue Cycle operations, the Senior Analyst will lead strategic project implementations. Additionally, this position will ... by analyzing data and identifying process improvement opportunities. The Senior Analyst will apply analytical and critical thinking to develop innovative solutions… more
- Evolent (Austin, TX)
- …contribute to Evolent's broader mission. **Collaboration Opportunities:** The Senior Analyst , Performance Suite Analytics utilizes and develops analytic tools to ... and articulating our value.** **Perform research and analysis of complex healthcare claims , eligibility, and pharmacy data to make recommendations based on relevant… more
- The Cigna Group (Plano, TX)
- **Position Title:** SAP Vistex Analyst /Configurator: Pricing, Chargebacks, Rebates, Pharma Billing **Position Overview:** CuraScript SD a wholesale pharmaceutical ... Company. CuraScript SD is seeking an experienced and highly motivated SAP Vistex analyst /configurator to join its technology team. This role will be supporting the… more
- Molina Healthcare (Austin, TX)
- …and claims functionality. Requires assistance with schema from Tech resource or Lead Analyst . + Writes Requirements for BRDs/FRDs and Reports. + Complex ... and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive...and existing health plans. + Completes analysis on retroactive claims reports + Pre and post validation of complex… more
- Sedgwick (Irving, TX)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer IT Systems Analyst Specialist **PRIMARY PURPOSE** : To review, analyze and document software ... requirements and to lead the business analysis phase for projects. **ESSENTIAL FUNCTIONS...combination of education and experience required. Experience in multi-line claims management processes and system requirements preferred. **Skills &… more
- Capgemini (El Paso, TX)
- …assigned by senior staff under supervision. Deepening knowledge in one process or more. To lead a team to make sure that the set target for quality and production is ... assigned by senior staff under supervision. Deepening knowledge in one process or more. To lead a team to make sure that the set target for quality and production is… more
- Elevance Health (Grand Prairie, TX)
- **Business Information Analyst Sr.** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live within 50 ... miles of one of Elevance's Pulse Point locations. The **Business Information Analyst Sr.** is responsible for analyzing, reporting and developing recommendations on… more
- Molina Healthcare (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...for business data issues as assigned by the team lead . + Analyze data sets and trends for anomalies,… more
- Molina Healthcare (Fort Worth, TX)
- **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of smaller scale, less complex vendor activities. Provides ... manages email correspondence between vendors, functional counterparts, and stakeholders ( Claims , Enrollments, IT, Health Plan, Core Operations) + Performs… more
- Lumen (Austin, TX)
- …connect the world and shape the future. **The Role** We are seeking a Lead Product Marketing Manager to drive the creation and delivery of unique market positioning ... to identify and develop valuable messaging that will drive engaging content. The Lead Product Marketing Manager is expected to be a content marketing expert across… more