- Elevance Health (Grand Prairie, TX)
- ** Provider Contract Cost of Care Analyst Senior** **Location:** This role requires associates to be in-office 1-2 days per week, fostering collaboration ... granted as required by law. The ** Provider Contract Cost of Care Analyst...or any combination of education and experience which would provide an equivalent background. **Preferred Skills, Capabilities, and Experiences:**… more
- Elevance Health (Grand Prairie, TX)
- ** Provider Contract Cost of Care Consultant - VBC** **Location** : This role requires associates to be in-office 1-2 days per week, fostering ... granted as required by law. The ** Provider Contract Cost of Care Consultant...or any combination of education and experience, which would provide an equivalent background **Preferred Skills, Capabilities, and Experiences:**… more
- Health Care Service Corporation (Richardson, TX)
- …take corrective action as needed 6. Oversee the performance of negotiated health care provider compensation and appropriate reimbursement of medical costs 7. ... strategies * Experience proactively developing and maintaining relationships with health care provider leadership teams with propensity to build trust… more
- Health Care Service Corporation (Richardson, TX)
- …more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost -effective health care and equipping our members with information and tools ... your professional development. **Job Summary** This position is responsible overall provider relations and oversees the following: the development and management of… more
- Health Care Service Corporation (Richardson, TX)
- …more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost -effective health care and equipping our members with information and tools ... will invest in your professional development. **Job Summary** The Advanced Contract Specialist is responsible for developing master documents and/or account-specific… more
- Molina Healthcare (Dallas, TX)
- …with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract /Re-contracting with large scale entities ... cost control initiatives to positively influence the Medical Care Ratio (MCR) in each contracted region. * Leads...department and organization. * Oversees the maintenance of all Provider Contract templates including VBP program templates.… more
- Molina Healthcare (Dallas, TX)
- …Duties** This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and ... of medical group/IPA and hospital contracting. * Identified as contract system lead by developing and maintaining provider...: Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider… more
- Molina Healthcare (Dallas, TX)
- …Maintains contractual relationships with significant/highly visible providers. + Advises Network Provider Contract Coordinators and Specialists on negotiation of ... Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. + Develops and maintains provider contracts in APTTUS contract management software. + Targets… more
- Molina Healthcare (Dallas, TX)
- …area.) **Job Qualifications** **REQUIRED EDUCATION** : Associate's Degree or equivalent provider contract , network development and management, or project ... customer service, provider service, or claims experience in a managed care setting. * Working familiarity with various managed healthcare provider … more
- Planate Management Group LLC (Dallas, TX)
- …and cost structures + Experience producing competitive commercial estimates and assessing cost risks. + Familiarity with contract terms, cost realism, ... facilities engineering services worldwide. Planate is a small business provider of planning, design, infrastructure management, technical consulting, engineering,… more
- CVS Health (Irving, TX)
- …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... all with heart, each and every day. **Position Summary** The Manager, Legal Contract Management will be responsible for carrying out reviews of general contracts to… more
- Baylor Scott & White Health (Dallas, TX)
- …to internal business needs and external supply markets that can impact contract performance for assigned spend categories, and suggests modifications to sourcing ... required by the business. Drives performance that results in year over year cost reductions through the standardization of products and pursuit of best possible… more
- RTX Corporation (Mckinney, TX)
- …Estimate-at-Completion (EAC) development. + Establish and maintain program logs (Work Authorization, Contract Mod Log, R&Os). + Provide financial guidance to ... only US citizens are authorized to access information under this program/ contract . **Security Clearance:** None/Not Required At Raytheon, the foundation of… more
- Health Care Service Corporation (Richardson, TX)
- …This position is responsible for performing moderate to complex Value Based Care Provider performance financial analyses. Some level of financial modeling ... level presentations related to financial topic + Ability to inform VBC provider contract performance risks, and collaborate cross-functionally to perform… more
- Elevance Health (Grand Prairie, TX)
- …The **Manager Senior Engineering** is responsible for providing analytical support to the Cost of Care and/or Provider Contracting organizations. **How you ... realized and recommends modifications as applicable. + Recommends standardized practices to optimize cost of care . + Educates provider contractors on… more
- Centene Corporation (Dallas, TX)
- … members and their families/caregivers on topics such as preventive care , procedures, healthcare provider instructions, treatment options, referrals, prescribed ... of care and service delivery for long-term care members in a cost -effective manner +...**Licensed Behavioral Health Professional or RN based on state contract requirements: LCSW, LPC or RN with direct Behavioral… more
- Baylor Scott & White Health (Dallas, TX)
- … provider research and network adequacy assessments, policy development, contract development, provider solicitation, and health system-aligned expansion of ... monitors network performance (including quality, utilization, network retention "keepage", and total cost of care performance), and the leader's team along with… more
- Molina Healthcare (Dallas, TX)
- …outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost -effective member care . **ESSENTIAL JOB ... regulations. **REQUIRED QUALIFICATIONS:** + At least 12 years of experience in health care leading state Medicaid long-term care services programs in a… more
- Elevance Health (Grand Prairie, TX)
- **JR168679 Behavioral Health Care Manager I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health ... assessment and short-term problem resolution and referral to appropriate provider (s). **Location:** Virtual: This role enables associates to work virtually… more
- Molina Healthcare (Dallas, TX)
- …claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and ... cost containment reports and makes recommendations based on relevant...materials and documentation archives. + Demonstrate Healthcare experience in contract modeling, analyzing relevant Financial and Utilization Metrics of… more