- Humana (Austin, TX)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to...member PHI / HIPAA information + This is a remote position\#LI- Remote **Scheduled Weekly Hours** 40 **Pay… more
- Merck (Austin, TX)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages ... questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support, and… more
- EPAM Systems (Austin, TX)
- **This Remote Position Cannot be Performed in New York City.** You are a natural leader and a proven operator at the most senior levels of clients in the insurance ... - go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit,… more
- Prime Therapeutics (Austin, TX)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Director Account Management, PACE - Remote **Job Description** + Owns overall ... Management Centers (CMC) and Shared Services, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis… more
- Takeda Pharmaceuticals (Austin, TX)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure...around the world. This position is currently classified as " remote " in accordance with Takeda's Hybrid and Remote… more
- Merck (Austin, TX)
- …collaboration to further differentiate our portfolio. The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, or PharmD) therapeutic ... external medical and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs provide to… more
- Molina Healthcare (Austin, TX)
- …and other end users for operational and strategic analysis. **Knowledge/Skills/Abilities** The Director of Reporting & Analytics is a key leader within the ... BI_** + **_Clinic Systems experience - CCA_** + **_Experience with CM, UM, Claims , or Authorizations_** To all current Molina employees: If you are interested in… more
- Molina Healthcare (Austin, TX)
- …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, ... MCO, Medicare, Medicaid, Market Place products, laws, rules and regulations **Preferred Education** * Master's degree **Preferred Experience** * Formalized training/experience in Health Care Insurance Fraud * Experience with Power BI, SAS, SQL other reporting… more
- United Therapeutics (Austin, TX)
- …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... Compliance departments related to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other healthcare related laws and… more
- Danaher Corporation (Austin, TX)
- …the Danaher Business System which makes everything possible. General Description: The Director of Global Health Economics & Outcomes Research (HEOR) will lead the ... value of Cepheid's diagnostics portfolio. Reporting into the Senior Director of Global HEOR, in this highly visible role...of the Value and Access team and will be remote . At Cepheid, our vision is to be the… more
- Merck (Austin, TX)
- **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater ... analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization… more
- Humana (Austin, TX)
- …The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Western Digital (Austin, TX)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... requirements. + Insure the proper and efficient handling of claims as they relate to workers' compensation insurance requirements....to be performed in California, Colorado, New York or remote jobs that can be performed in California, Colorado… more
- Prime Therapeutics (Austin, TX)
- …drives every decision we make. **Job Posting Title** Pricing Analyst - Remote **Job Description** The Pricing Analyst maintains, provides analyses, consults and ... with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness &… more
- Prime Therapeutics (Austin, TX)
- …we make. **Job Posting Title** Sr. Pricing Analyst - Pharmacy Network - Remote **Job Description** The Senior Pricing Analyst participates in the assessment of value ... revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other...to adjust focus **Reporting Structure** + Reports to Manager, Director , or Senior Director in the Network… more
- Prime Therapeutics (Austin, TX)
- …**Job Posting Title** PBM Sr Business Intelligence Data Visual Consultant - Remote **Job Description** The Senior Data Visualization Consultant is responsible for ... new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
- Mathematica (Austin, TX)
- …data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and ... and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through… more
- Prime Therapeutics (Austin, TX)
- …and drives every decision we make. **Job Posting Title** Underwriter - Remote **Job Description** The Underwriter is responsible for assisting in the development ... Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims data +… more
- Prime Therapeutics (Austin, TX)
- …we make. **Job Posting Title** Senior Business Integration Consultant - Remote **Job Description** The Senior Business Integration Consultant is responsible for ... efforts + Proficiency in one or more of the following areas: claims , eligibility, prior authorization, accumulators, and/or benefits + Previous PBM or healthcare… more
- Prime Therapeutics (Austin, TX)
- …every decision we make. **Job Posting Title** Treasury Reporting Principal - Remote **Job Description** The Treasury Analyst Principal is responsible for managing, ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more