• Director , Strategy Advancement…

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** The Director , Strategy Advancement provides data-based strategic direction to identify and address ... planning support for business segments or the company at large. The Director , Strategy Advancement requires an in-depth understanding of how organization… more
    Humana (05/09/25)
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  • Director Pharmacy Financial Strategy

    Highmark Health (Austin, TX)
    …Highmark Inc. **Job Description :** **JOB SUMMARY** As part of the enterprise strategy to integrate and scale pharmacy solutions that disrupt the pharmacy supply ... responsible for the execution and value realization related to strategy development, operational excellence, pricing optimization, vendor coordination, and assisting… more
    Highmark Health (05/06/25)
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  • Executive Director , Compliance

    NASCO (Austin, TX)
    …parent's Enterprise Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship ... **Overview** As Executive Director , Compliance you will lead and provide oversight...Medicare Advantage and Exchange customers, including contract management, strategy development, operational delivery and invoicing + Engages with… more
    NASCO (04/16/25)
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  • Director , Stars HOS Improvement…

    Humana (Austin, TX)
    …our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates ... Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
    Humana (05/13/25)
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  • National Contracting Director (Value Based…

    Molina Healthcare (Austin, TX)
    **Job Description** **Job Summary** The National Program Director - Value-Based Care is a strategic leadership role responsible for the development, implementation, ... evolution of value-based care (VBC) programs across all lines of business-Medicaid, Medicare , and Marketplace. This role is critical in driving clinical and… more
    Molina Healthcare (04/24/25)
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  • Insurance Strategy Lead

    Humana (Austin, TX)
    …of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy , and identifying improvement opportunities for a ... projects from concept to execution **Additional Information** This role reports to the Director of Strategy , works collaboratively with members of rest of the… more
    Humana (05/08/25)
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  • Regional Director , Quality Solutions…

    Molina Healthcare (Austin, TX)
    …ideally suited for candidates living in the Eastern Time Zone. Regional Director Quality Solutions (QS) is responsible for contributing to the strategic performance ... as the subject matter expert for all, Medicaid / Medicare / Marketplace quality, and data acquisition functions to...and MHI QS that enables staff and communicates the strategy and roadmap ongoing to health plan leadership. +… more
    Molina Healthcare (04/30/25)
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  • IPA Coding Associate Director

    CenterWell (Austin, TX)
    …are followed, and fosters collaboration across entities within the Primary Care Organization. ** Strategy :** + In partnership with AVP, Risk Adjustment and AVP, MRA ... Strategy , responsible for driving ongoing efficiency and effectiveness of...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record… more
    CenterWell (04/24/25)
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  • Associate Director , Data Quality/Integrity…

    Humana (Austin, TX)
    …diverse scope and complexity ranging from moderate to substantial. The Associate Director , Data Quality/Integrity will lead and manage the HEDIS Supplemental Data ... metrics, documentation, quality controls, reporting, and exceptional delivery. The Associate Director will be responsible for ensuring the team lives Humana's… more
    Humana (05/06/25)
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  • Director , Employer Group Distribution…

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** The Director , Employer Group Distribution is responsible for leading a field-based team who sells ... of all sizes within an assigned Group Market. The Director is responsible for leading business relationships with employer...contributor on local market insights to the Group Growth Strategy . Se + Provide customer, broker and partner insights… more
    Humana (05/06/25)
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  • Trade Client Relations Director - Remote

    Prime Therapeutics (Austin, TX)
    …and drives every decision we make. **Job Posting Title** Trade Client Relations Director - Remote **Job Description** The Trade Client Relations Director is ... related product development and implementation + Lead and coordinate work for Prime's Medicare Center of Excellence, maintaining an in depth understanding of work in… more
    Prime Therapeutics (04/17/25)
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  • Director , Actuarial Services - Transform…

    Evolent (Austin, TX)
    …as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to solve ... teams of actuaries and non-actuaries, including support for team engagement and strategy + Present reports and analyses to clients and internal executives… more
    Evolent (03/22/25)
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  • Senior Director , Business Operations

    Centene Corporation (Austin, TX)
    …development, and implementation programs centered on quality and operations excellence for Medicare Duals programs. + Develop and monitor service levels to ensure ... all membership related initiatives including identification of business need, strategy recommendation, project outline, management of deliverables, and ROI across… more
    Centene Corporation (05/15/25)
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  • National Contracting Director

    Molina Healthcare (Austin, TX)
    …* Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). ... and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates.… more
    Molina Healthcare (03/04/25)
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  • Print Project Manager 2

    Humana (Austin, TX)
    …put health first** The Print Project Manager 2 will report to the Associate Director of Enterprise Print Management and will be involved in the production and ... and outside print vendors. + Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. +… more
    Humana (05/06/25)
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  • BCBA-D ABA UM Reviewer

    Humana (Austin, TX)
    …to facilitate optimal care and treatment. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues regarding technical ... This position reports directly to the Behavior Health Lead Medical Director . **Requirements:** . BCBA-D with Florida licensure or credentialing . Prior… more
    Humana (05/07/25)
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