- Prime Healthcare (Farmers Branch, TX)
- …trends and identify opportunities for process improvement and reimbursement optimization. Complex Claims Management:identifies, trends, and owns portfolios of ... team! If you wish to contribute to the Prime Healthcare legacy as a Corporate Director , Patient...complex claims , including Third party claims , TDRG, Zero… more
- Elevance Health (Plano, TX)
- …senior management and prior leadership experience preferred. + Finance experience in a complex healthcare business, with complex data, such as Specialty ... **Be Part of an Extraordinary Team** **Finance Director - Paragon Healthcare ** _A proud...and reporting experience with large data sets such as claims data, drug therapy data, profitability analysis, gross margin… more
- Humana (Austin, TX)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …our focus to ultra-rare neurological conditions. **Job Summary** The Executive Director , Sales and Marketing, Neurology Rare Disease will be responsible for ... This role involves leading HCP and patient engagement, understanding the evolving complex journey to diagnosis, leading account teams, and aligning with the broader… more
- Evolent (Austin, TX)
- …Management** and **Product Management** , leveraging advanced analytics to solve complex healthcare challenges and support impactful decision-making that ... Codes, CPT Codes, RVUs, bundled payments, etc. + Working knowledge of healthcare claims ; specifically, differences between institutional vs professional billing… more
- Evolent (Austin, TX)
- …or related healthcare consulting entity + Extensive knowledge of healthcare claims ; specifically, differences between institutional vs professional billing ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...+ At least 5 years of professional experience in claims -based healthcare analytics with a payer, provider,… more
- Baylor Scott & White Health (Dallas, TX)
- …individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core ... litigation matters. Reporting to the system Vice President overseeing claims for Baylor Scott & White Health (BSWH). The... for Baylor Scott & White Health (BSWH). The Director -Assistant General Counsel (Dir-AGC) will represent BSWH system in… more
- Evolent (Austin, TX)
- …rates, turnaround times, PMPM, trend drivers), with a working knowledge of healthcare claims and reimbursement methodologies. + Experience presenting actionable ... Be Doing: + Strategic Data Analytics & Insights: Lead advanced analyses of healthcare authorization, claims , membership data, and clinical outcomes to uncover… more
- Akumin (Houston, TX)
- We are seeking an experienced, strategic, and results-driven Senior Director of Billing and Collections to lead our end-to-end billing operations. This senior ... oversee all facets of the billing lifecycle, including charge capture, claims management, collections, cash application, denial resolution, and system optimization.… more
- Humana (Austin, TX)
- …Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness and… more
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