- Sedgwick (Fort Worth, TX)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Management and Executive Risk Claims Manager **PRIMARY PURPOSE** **:** To manage the ... policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps… more
- Molina Healthcare (Fort Worth, TX)
- …cutover planning, and post-go live stabilization. + Hands-on governance, quality assurance, risk management , and escalation handling in a regulated environment ... requirements, configuration, and testing for platforms such as Salesforce (case management , integrations), QNXT (or similar core claims ), RPA/automation, and… more
- Sedgwick (Fort Worth, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. Executive General Adjuster - Southwest Region **PRIMARY PURPOSE** **:** To investigate… more
- Sedgwick (Fort Worth, TX)
- …the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating ... Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Executive General Adjuster - Southwest Region **PRIMARY PURPOSE** : To investigate … more
- HCA Healthcare (North Richland Hills, TX)
- …Executive Committee and Board of Trustees. Include the patient's story of harm. ** Risk Management / Claims Activities (if not otherwise assigned):** + Work ... will alleviate identified gaps. **Identification and Mitigation of Patient Safety Risk Expectations:** + Effectively report, investigate, and analyze patient safety… more
- Molina Healthcare (Fort Worth, TX)
- …of provider reimbursement changes + Provide data driven analytics to Finance, Claims , Medical Management , Network, and other departments to enable critical ... sources. + Knowledge of healthcare operations (utilization management , disease management , HEDIS quality measures, claims processing, etc.) + Knowledge of… more
- Texas Health Resources (Arlington, TX)
- …optimization and competitive advantage. Develop and maintain databases and data management systems to support business needs, strategic pricing, price transparency ... and market analysis initiatives. Utilize contract management and pricing tools to create scenario-based frameworks and models to simulate pricing scenarios, forecast… more
- BrightSpring Health Services (Arlington, TX)
- …and upholds the agency's mission and values. Working closely with the Executive Director and leadership team, the Program Manager leads staff, coordinates ... individualized supports, ensures quality outcomes, manages risk , and supports strategic initiatives, census development, and operational growth. Responsibilities +… more
- Burns & McDonnell (Fort Worth, TX)
- …reports to Project Manager, Program Manager as well as internal and external executive management as required. + Collaborate with engineering team to establish ... contract administration including request for information (RFI's), submittals, change management , contract closeout, documentation, and claims mitigation. +… more
- Molina Healthcare (Fort Worth, TX)
- …weekly/monthly/quarterly/annually standard reports. + Must have experience in analyzing Utilization management , member health risk assessment data using SQL, ... **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network...using PowerBI + Must be able to collaborate with Executive teams in Utilization management , Operations, Core… more