- Fresenius Medical Center (Dallas, TX)
- … programs (HMOs, PPOs, POS, etc). Oversees Division's contractual relationships with managed care organizations and other third party payors regarding rate ... financial effect, cost benefit and utilization. + Negotiates contractual relationships with managed care organizations and other third party payors as needed.… more
- Baylor Scott & White Health (Dallas, TX)
- …the hospital, and BSWH. Develops guidelines for working with insurers, managed care organizations, referral providers, patients, and families. Monitors ... **JOB SUMMARY** Director , Comprehensive Care Management (CCM) is a System Director responsible for planning, developing, and implementing the comprehensive … more
- Baylor Scott & White Health (Dallas, TX)
- …denials. This role serves as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline payer communications. The ... a matrixed organizational structure, collaborating closely with teams across Revenue Cycle, Managed Care , Finance, and Operations. **Essential Functions of the… more
- Molina Healthcare (Dallas, 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
- Baylor Scott & White Health (Dallas, TX)
- …for overseeing the enrollment of BSWH facilities and providers with government and managed care payers, ensuring all processes comply with regulatory and payer ... **Job Summary** The Director , Provider Enrollment, is responsible for the strategic...payer enrollments and claims submission. Collaborates with Legal, Compliance, Managed Care , Medical Staff Services, Government Finance,… more
- Elevance Health (Grand Prairie, TX)
- …Financial, Business, and Leadership acumen strongly preferred. + Prior experience with managed care , trend & healthcare analytics, provider networks, claims, ... **Business Strategy Plan Director (Business Stat Plan Dir)** Location: This role...+ Identifies and develops best practices and cost of care improvement processes around physician, hospital and ancillary network… more
- Molina Healthcare (Dallas, 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
- S&P Global (Dallas, TX)
- …Role:** **Grade Level (for internal use):** 12 **About the Role:** **Associate Director , Fixed Income Index Calculation and Distribution** **The Team:** The Fixed ... of accuracy and integrity. Collaborating with cross-functional teams, the Associate Director will ensure calculation inputs are validated, oversee calculations and… more
- Prominence Advisors (Dallas, TX)
- Prominence Advisors is actively seeking a Director of Analytics to join their team. Director of Analytics provides leadership for all activities related to Data ... and activities to ensure projects are prioritized and properly managed . This includes managing project timelines, budgets, resource forecasting...at their fingertips in order to deliver higher quality care at a lower cost. Ranked as a best… more
- Molina Healthcare (Dallas, TX)
- …new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified ... services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to… more
- WTW (Dallas, 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...coverage), Dental, Vision, Health Savings Account, Commuter Account, Health Care and Dependent Care Flexible Spending Accounts,… more
- Fresenius Medical Center (Irving, TX)
- …with management and executives to determine appropriate plan of action. Supports Managed Care staff in budgeting and forecasting activities. PRINCIPAL DUTIES ... + Responsible for timely and accurate communication of revenue reporting to Managed Care Management Team. + Responsible for compliance with all related data… more
- YesCare Corp (Waxahachie, TX)
- …healthcare services, YesCare is committed to innovation, clinical expertise, and compassionate care . By choosing a career with YesCare, you are opting for ... full career potential. Your role at YesCare allows you to contribute directly to the care and well-being of patients who need it most. Join a team that's known for… more
- Molina Healthcare (Dallas, TX)
- …new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified ... for both members and providers and ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide… more
- Zimmer Biomet (Dallas, TX)
- …effect action that will exploit the markets and actualize sales potential in the managed care arena. * Coordinates the development and application of appropriate ... measures for monitoring performance against contracted sales and profit objectives in assigned accounts and controlling contract actions to accommodate contingencies revealed by controls. * Coordinates outside contacts with internal Zimmer Biomet personnel. *… 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 ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Knowledge of integrated… more
- Veterans Affairs, Veterans Health Administration (Dallas, TX)
- …manager who occupies a key management position at the VA North Texas Health Care System (VANTHCS). The DLO serves as a senior educator within the VANTHCS liaison ... Education and Learning Resources Service, VA North Texas Health Care System Responsibilities Duties include but are not limited...programs were sanctioned by the VHA Central Office Program Director for Psychology and the VHA Office of Academic… 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 ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and… more
- Molina Healthcare (Dallas, TX)
- …least 12 years experience in health care , and at least 10 years of managed care experienced in one or more of the following areas: utilization management, ... professionals, in some or all of the following functions: utilization management, care management, care transitions, behavioral health, long-term services and… more
- Molina Healthcare (Dallas, TX)
- …a minimum of 2 years of experience in health plan quality improvement, managed care , or equivalent experience + Demonstrated solid business writing experience ... during the year + Works with the Manager and/or Director to maintain up-to-date addendums to quality policies and...gaps at the direction of the with Manager and/or Director + Other tasks, duties, projects, and programs as… more