- HealthCare Support (Odessa, TX)
- …Support is actively seeking a Case Manager to fill an opening with a Managed Care Company in Odessa, TX . Daily Responsibilities for Case Manager : ... Conduct screening and risk assessment interventions per program guidelines. LTSS service care manager will have 3 days of travel for visits seeing the members… more
- PharmaCord (Austin, TX)
- When you join the team as an Executive Case Manager , you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as ... prescriptions or cases are handled in a timely manner. An Executive Case Manager has the ability to translate knowledge into patient friendly language and education.… more
- HealthCare Support (Houston, TX)
- …prior to processing authorization requests. Accurately enters the required information into the managed care platform, adhering to UM policies and procedures. 5. ... clinical information to authorize medically necessary inpatient and outpatient care , utilizing nationally recognized evidenced based clinical criteria or approved… more
- Cardinal Health (Austin, TX)
- …companies (ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing ... **_What Managed Care contributes to Cardinal Health_**...other activity as it relates to payer interaction. The Manager of Payor Contracting is responsible for reviewing, auditing… more
- Charles Schwab (Westlake, TX)
- …responsible for managing our third-party product marketplaces (Alternative Investments, Managed Accounts, Mutual Funds, ETFs, Structured Products, Fixed Income, ... Insurance, and 529) as well as our proprietary Separately Managed Accounts. Our mission is to provide a positive...platforms to be more modern and competitive The Senior Manager is an individual contributor role that is vital… more
- Molina Healthcare (San Antonio, TX)
- …QUALIFICATIONS:** + At least 6 years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, ... integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape… more
- Molina Healthcare (Austin, TX)
- …years of experience in a pharmacy, Medication Therapy Management (MTM), Pharmacy Benefit Manager (PBM), and/or managed care setting, or equivalent combination ... Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care . **Essential Job… more
- Indeed (Austin, TX)
- …policy, and many region-specific benefits. **Benefits - Health, Work/Life Harmony, & Wellbeing** We care about what you care about. We have a multitude of ... benefits to support Indeedians, as well as their pets, kids, and partners including medical, dental, vision, disability and life insurance. Indeedians are able to enroll in our company's 401k plan, as well as an equity-based incentive program. Indeedians will… more
- Molina Healthcare (TX)
- …* At least 8 years clinical systems experience, preferably as a product owner / manager within a managed care , nursing informatics or health care ... implementation, and oversight of technology that drives core utilization management, care management, long-term services and supports (LTSS), clinical operations and… more
- Molina Healthcare (Houston, TX)
- …Qualifications** * At least 3 years of experience in a pharmacy, Pharmacy Benefit Manager (PBM), formulary, and/or managed care setting, and 1-2 years ... team (ICT). * Works with the Pharmacy Benefit Manager (PBM) to manage formulary changes and update marketing...Qualifications** * Medicare Part D and/or Medicaid experience. * Managed care experience. To all current Molina… more
- Guidehouse (San Antonio, TX)
- …adherence to company/client standards and communicate issues of non-compliance to Operations Manager + Monitor specialist performance to ensure they meet or exceed ... metrics as needed + Identify and communicate trends and issues to Operations Manager , additional Project Leaders & Client + Perform other duties, tasks, and special… more
- Health Care Service Corporation (Waco, TX)
- …of operations within 90 days of hire. + Plus 3 years' wellness or managed care experience presenting clinical issues with members/physicians. + Knowledge of the ... your professional development. **Job Summary** This position is responsible to provide care coordination to members via telephonic and/or field-based care … more
- Molina Healthcare (El Paso, TX)
- …and productivity is important. Preferred candidates will have previous case management, managed care , inpatient hospital experience._ _TRAVEL in the field to ... unrestricted RN license in the state of TX._ _Case Manager RN will work Hybrid (Telephonic and face to...**Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health… more
- Houston Methodist (Houston, TX)
- …by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, state, and federal ... At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse...language principles + Comprehensive knowledge of Medicare, Medicaid and Managed Care requirements + Comprehensive knowledge of… more
- Molina Healthcare (Dallas, TX)
- …to those candidates with previous experience working with the Medicaid population within a Managed Care Organization (MCO). Mileage is reimbursed as part of our ... Long Term Services & Supports. + 1-3 years in case management, disease management, managed care or medical or behavioral health settings. + Required License,… more
- Molina Healthcare (Jacinto City, TX)
- …to those candidates with previous experience working with the Medicaid population within a Managed Care Organization (MCO). Mileage is reimbursed as part of our ... consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex...care , including at least 1 year experience in care management, managed care , and/or… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** Opportunity for a Texas licensed RN to join Molina as a Care Manager working with DSNIP members. The case load will include members who are ... who have experience supporting the LTSS population as a Care Manager with another MCO are highly...**Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health… more
- Molina Healthcare (TX)
- …Nursing preferred. **Required Experience** 1-3 years in case management, disease management, managed care or medical or behavioral health settings. **Required ... in Nursing **Preferred Experience** 3-5 years in case management, disease management, managed care or medical or behavioral health settings. Preferred License,… more
- Humana (Austin, TX)
- …+ BSN or MSN degree + Knowledge of Milliman or Interqual + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see ... part of our caring community and help us put health first** The Care Manager , Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members'… more
- CenterWell (Dallas, TX)
- …degree in nursing or business health field + Previous experience working in a managed care field + 5 or more years of previous management/supervisor level ... caring community and help us put health first** **The Role** The Care Integration Team Manager is responsible for managing a team of nurses, community health… more
