- Houston Methodist (Houston, TX)
- At Houston Methodist, the Director Managed Care Contracting position is responsible for the development, negotiation, maintenance and payer relations of ... + Knowledge of acute care contracts, financial modeling techniques and managed care contracting , contract pricing, language requirements, rates and… more
- Cardinal Health (Austin, TX)
- …(ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing legal ... that take place between payer and provider(s) to ensure optimal reimbursement including managed care contracting , enrollment, credentialing, and any other… more
- Molina Healthcare (Houston, TX)
- …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including ... Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with… more
- Baylor Scott & White Health (Dallas, TX)
- …of 5 years of progressive experience in healthcare revenue cycle, payer relations, or managed care contracting . Experience in a matrixed or integrated ... of the Vice President, Revenue Cycle Support Services, the Director , Payer Performance leads Revenue Cycle's strategic efforts to...as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline… more
- Sanofi Group (Dallas, TX)
- …functional areas of the business (eg Sales Training, Customer Solutions, Sales Operations, Managed Care and Marketing) **Why Choose Us?** + Bring the miracles ... **Job Title:** Area Business Director - Portfolio **Location:** US Remote/Field **About the...care or vaccine products + Knowledge of the managed market dynamics and competitive landscape in the acute… more
- Molina Healthcare (Austin, TX)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Highmark Health (Austin, TX)
- …Insurance, Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population ... drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark Health… more
- UTMB Health (Galveston, TX)
- …pay or regulatory requirements. + Thorough knowledge of Hospital reimbursement and managed care contract issues. + Knowledge of automated systems that ... Director of Hospital Accounts Receivable **Galveston, Texas, United...of management and operational staff. + Works closely with contracting to ensure optimal payer contract terms and is… more
- Molina Healthcare (Dallas, TX)
- …+ 10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization decisions are...Director + Demonstrated experience in Utilization/Quality Program management +… more
- Stantec (Plano, TX)
- When you care deeply about the work you do, it's rewarding to see it through from concept to completion. We partner with clients to provide both program management ... transit systems, water treatment facilities, mines, and wind farms, we've successfully managed thousands of projects. Joining our team, turning visionary ideas into… more
- Community Health Systems (Longview, TX)
- …efficient service delivery, regulatory compliance, and financial sustainability across all managed practices. The Director collaborates with physicians, hospital ... & Reward Programs + Exclusive Discounts & Perks* **Job Summary** The Director , Practice Management is responsible for the operational, financial, and clinical… more
- Molina Healthcare (Houston, TX)
- …* 3 years' experience in Utilization/Quality Program Management * 2+ years HMO/ Managed Care experience * Experience demonstrating strong management and ... dependency services and assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- Evolent (Austin, TX)
- …professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care , or related healthcare consulting entity + Extensive ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more
- WTW (Houston, TX)
- …organization, health benefits consulting or brokerage environment, health insurance carrier, managed care organization or another leading health care ... **Description** As a Health Analytics Director you will partner with other Senior Consultants...plans; finalize and present deliverables to clients + Lead contracting efforts, including coordinating with client procurement and/or legal… more
- Molina Healthcare (Dallas, TX)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Knowledge of integrated delivery… more
- Takeda Pharmaceuticals (Dallas, TX)
- …tools for Territory and Data Analytics to monitor and evaluate accounts, industry/ managed care trends and communicate relevant information to Accounts and ... selling opportunities and adaptability to changing market conditions + Understanding of managed care landscape and how it influences/impacts business + Strong… more
- HCA Healthcare (San Antonio, TX)
- …+ Provides medical consultation on contracting , pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
- Prime Therapeutics (Austin, TX)
- …including pharmaceutical manufacturers, with specific emphasis on Medicare Part D and Managed Medicaid. The Sr Director , Pharm Trade Relations leads a ... Sr Dir Pharmacy Trade Relations - Remote **Job Description** The Sr Director , Pharmaceutical Trade Relations is responsible for managing Prime's Trade Relations… more
- Methodist Health System (Dallas, TX)
- …work relationships with coworkers and health plan representatives. **Job Roles:** + Supports managed care contracting + Research healthcare updates online + ... The Provider Services Coordinator provides administrative support to the Director of Contracting and Network Development, as...website + Assist with projects as needed **Age Specific Care Considerations:** ☐ Adults: 18+ years - 35 years… more
- Apex Health Solutions (Houston, TX)
- …Minimum of three (3) years of experience in a hospital, a physician setting or a Managed Care Organization as a medical coder. * Minimum of five (5) years ICD-10 ... CM coding experience required. * Current AAPC or AHIMA credential required. * Managed Care Experience preferred. * Knowledge of Medicare Risk Adjustment… more