- Molina Healthcare (TX)
- …The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace lines of ... business . This includes direct management of internal teams and...experience across a wide range of subrogation case types-including automobile- related claims (eg, no-fault/PIP), workers' compensation, general liability, medical… more
- Molina Healthcare (San Antonio, TX)
- …equivalent discipline **Required Experience** + 3-5 Years of experience with healthcare - related data (claims/encounters, provider, CMS/EDGE response files, etc. ... Success in this role requires a blend of strong technical acumen, business context, and analytical curiosity. While data is primarily accessed through Databricks,… more
- Molina Healthcare (El Paso, TX)
- …clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid). Executes health plan's member and community ... a lead specialist to provide project, program, and/or initiative related direction and guidance for other specialists within the...education and work experience. + 3 years' experience in healthcare with a minimum of 2 years' experience in… more
- Prime Therapeutics (Austin, TX)
- …as needed. + Other duties as assigned **Minimum Qualifications** + Bachelor's degree in business , healthcare management or other related field of study or ... internally to evaluate rebate and formulary opportunities for Prime's business + Support client alignment and adoption of strategies;...diploma or GED is required. + 10 years of related work experience in healthcare , pharmacy benefit… more
- Molina Healthcare (TX)
- …provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other ... policies and procedures pertaining to department functions. * Produces reports related to provider network information. * Collaborates with local and corporate… more
- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to ... to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment + Builds positive relationships between providers and Molina… more
- Molina Healthcare (San Antonio, TX)
- …resolution of appeals, grievances, and/or complaints from Molina members, providers and related outside agencies. + Trains new employees and provides guidance to ... detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of… more
- Molina Healthcare (Austin, TX)
- …appeals, dispute, grievances, and/or complaints from Molina members, providers and related outside agencies to ensure that internal and/or regulatory timelines are ... detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of… more
- HCA Healthcare (Arlington, TX)
- …as a(an) Director Case Management? At Medical City Arlington, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible ... on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny… more
- HCA Healthcare (San Antonio, TX)
- …on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny ... you choose to focus on bedside care, a leadership or C-suite role, shape business and operational outcomes, or work to deliver clinical excellence behind the scenes… more