- Elevance Health (Grand Prairie, TX)
- ** Provider Contract Cost of Care Consult Senior / 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 Consult...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 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 (Fort Worth, 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 (Fort Worth, 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 (Fort Worth, 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 (Fort Worth, 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
- 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
- Jefferson Dental and Orthodontics (Fort Worth, TX)
- …Through our hands-on world class mentorship program, our Hygienists grow to provide comprehensive care to patients, maximizing their clinical, professional, and ... scanners, Overjet AI, Hygiene Lasers (we cover the certification cost ) + Training & Advancement with CEs included and...them achieve optimal oral health. Our commitment to comprehensive care , provider empowerment, and innovative technology has… 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
- 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 (Fort Worth, 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 (Fort Worth, 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
- Molina Healthcare (Fort Worth, TX)
- …delivery of care across the continuum. Contributes to overarching strategy to provide quality and cost -effective member care . Essential Job Duties * ... Assesses services for members to ensure optimum outcomes, cost -effectiveness and compliance with all state/federal regulations and guidelines. * Analyzes clinical… more