- 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
- 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
- Molina Healthcare (Houston, 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
- Molina Healthcare (Houston, 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
- 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
- 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 (Houston, 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
- 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
- Apex Health Solutions (Houston, TX)
- … coordination required; chronic disease management or population health preferred Managed care experience preferred Strong ability to demonstrate knowledge ... at risk for poor outcomes, the Case Manager establishes care plans and goals, and coordinates care ...services appropriate to the member being served. Reports to: Director , Health Services Location: Houston, TX area; will consider… more