- Molina Healthcare (San Antonio, TX)
- …Provider disputes and appeals to ensure adherence with Molina claims processing standards and provider contractual agreements. Includes responsibility from ... processed in accordance with local Health Plan requirements * Works with Claims , Configuration, Contracting, Provider Data Management, and other business partners to… more
- Centene Corporation (Austin, TX)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Director , Workforce Management serves as a business leader who will be ... and owning workforce management strategy, process, and execution for claims . Will focus on tactical and strategic plans, capacity...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Molina Healthcare (Fort Worth, TX)
- …by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- Centene Corporation (Austin, TX)
- …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Molina Healthcare (Fort Worth, TX)
- …rejections. Address a variety of enrollment questions or concerns received via claims , call tracking, or e-mail. Maintain records in the enrollment database. ... **Knowledge/Skills/Abilities** + Holds general oversight of enrollment and premium staff at each plan site within defined region. This may include employee reviews, coaching sessions and disciplinary actions. + Monitors and enforces compliance with… more
- Molina Healthcare (Fort Worth, TX)
- …5 years of experience in Medicare, DSNP and CSNP population, Enrollment, A&G, Claims , Compliance, or other Operations experience To all current Molina employees: If ... you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $88,453 -… more
- Molina Healthcare (Fort Worth, TX)
- …with AI Data Integration._** + **_Experience with Member, Enrollment, and Claims applications -_** **which underpin essential business functions such as HEDIS ... reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License, Certification, Association** Microsoft Technology, Mobility, ITIL To all current Molina employees: If you… more
- Lockheed Martin (Fort Worth, TX)
- **Description:** You will be the Associate General Counsel \- Director to lead the legal portfolio as part of the Senior Leadership for the Integrated Fighter Group ... new and current programs, develop and implement pursuit of claims to increase revenues/avoid losses, and attainment of other...Department\. **What's In It For You:** From onsite to remote , we offer flexible work schedules to comprehensive benefits… more
- Humana (Austin, TX)
- …The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
- Public Storage (Plano, TX)
- …are looking for a leader to join our Risk Management team as a Senior Director , Risk Management. This leader will partner and drive our Risk Management practice and ... Company's exposure to risk by formulating, developing, and coordinating claims -related activities on large claims , and resolving...with the option to take up to three flexible remote days per month. + Our office is based… more