- Evolent (Austin, TX)
- …to ensure clean and consistent tracking of Evolent's covered membership and claims + Synthesize complex analyses into succinct presentations for communication ... providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and...connected care journey. We are hiring for a Managing Director , Actuarial Services to join our Finance Team. The… more
- The Cigna Group (Austin, TX)
- …at enterprise scale. + **Executive presence** with the ability to simplify complex decisions and drive change through influence (high enterprise impact with a ... to Have** + Prior **PBM/specialty pharmacy** platform knowledge (eg, claims /benefit management, care coordination, specialty workflows). + Earlier **hands‑on… more
- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- …research, and correspond with insurance companies to obtain accurate reimbursement for healthcare claims . This person will also be responsible for analyzing, ... healthcare professionals to resolve issues resulting from denied claims + Adhere to coding policies and procedures consistent...missing charts. + Clarify documentation with the Physician and Director as needed. + Completes reports and logs as… more
- Molina Healthcare (Houston, TX)
- …& ABILITIES** : 1 year customer service, provider service, contracting or claims experience in the healthcare industry. **PREFERRED EDUCATION** : Associate's ... adequacy, financial performance and operational performance, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance… more
- Molina Healthcare (San Antonio, TX)
- …adequacy, financial performance and operational performance, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance ... accurate and timely maintenance of critical provider information on all claims and provider databases. Responsible for contracting/re-contracting of standard deals,… more
- Health Care Service Corporation (Richardson, TX)
- …(eg, agentic AI) is strongly preferred. * Previous experience working with insurance claims systems and/or healthcare experience * Experience with Iterative / ... drive revenue growth, improve our operational and member-facing processes, and affect how healthcare is delivered to our 17 million members. An ideal candidate is… more
- Prime Therapeutics (Austin, TX)
- …department and other key client functions as determined by the Sr. Director / Director . **Responsibilities** + Perform business analysis work for client-facing ... functions such as but not limited to customer service, claims , benefits, prior authorizations, rebates, and networks. + Build...create input to the business cases. + Support Sr. Director / Director and other key leaders in communication… more
- Humana (Austin, TX)
- …diverse scope and complexity ranging from moderate to substantial. The Pharmacy Director , internally known as a Clinical Pharmacy Lead, plans, directs, and monitors ... on matters of significance. + Exercises independent judgment and decision making on complex issues regarding job duties and related tasks. + Works under minimal… more
- Danaher Corporation (Dallas, TX)
- …Our mission drives us to develop groundbreaking solutions for the world's most complex health challenges. Together, we bring MORE change to the world. Learn about ... to customer inquiries. This position reports to the Senior Director Market Access Americas and is part of the...will have the opportunity to: + Provide education to healthcare providers, lab professionals, office staff and financial decision… more
- Mass Markets (Killeen, TX)
- …technology solutions across a wide range of industries, including healthcare , retail, government, education, telecom, technology e-commerce, and financial services. ... for the day-to-day activity and development of 5-10 supervisors within a complex call center environment. The Operations Manager position is responsible for ensuring… more