- Houston Methodist (Houston, TX)
- At Houston Methodist, the Director Managed Care Contracting position is responsible for the development, negotiation, maintenance and payer relations of ... + Knowledge of acute care contracts, financial modeling techniques and managed care contracting , contract pricing, language requirements, rates and… more
- Cardinal Health (Austin, TX)
- …(ex. Blue Cross, Blue Shield, IPA, etc). Reporting to the Director of Managed Care , the Manager of Contracting is responsible for managing legal ... between payer and provider(s) to ensure optimal reimbursement including managed care contracting , enrollment, credentialing,...with strategy. **Essential Functions:** + In collaboration with the Director of Managed Care , negotiate… more
- Molina Healthcare (Fort Worth, TX)
- …SKILLS & ABILITIES** : * 7+ years' experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including ... **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to… more
- Molina Healthcare (Austin, TX)
- …QUALIFICATIONS:** + At least 8 years of experience in Healthcare Administration, Managed Care , and/or Provider Network Management and Operations with an ... subject matter expertise for the design and implementation of value-based care programs across Medicaid, Medicare, and Marketplace populations, ensuring alignment… more
- Molina Healthcare (Fort Worth, TX)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate ...(QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
- Highmark Health (Austin, TX)
- …Insurance, Consulting or related area + 3 years Value-based reimbursement, through managed care contracting , provider reimbursement, consulting, population ... drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting , Market and Provider support teams, Actuary, Finance, Highmark Health… more
- UTMB Health (Galveston, TX)
- …pay or regulatory requirements. + Thorough knowledge of Hospital reimbursement and managed care contract issues. + Knowledge of automated systems that ... Director of Hospital Accounts Receivable **Galveston, Texas, United...of management and operational staff. + Works closely with contracting to ensure optimal payer contract terms and is… more
- Molina Healthcare (San Antonio, TX)
- …+ 10+ years relevant experience, including 5+ years of clinical practice and 3+ years HMO/ Managed Care experience **OR** 5 years experience as a Molina Medical ... inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization decisions are...Director + Demonstrated experience in Utilization/Quality Program management +… more
- Community Health Systems (Longview, TX)
- …efficient service delivery, regulatory compliance, and financial sustainability across all managed practices. The Director collaborates with physicians, hospital ... **Job Summary** The Director , Practice Management is responsible for the operational,...and business performance while maintaining a focus on quality care , patient access, and strategic growth. **Essential Functions** +… more
- Evolent (Austin, TX)
- …professional experience in claims-based healthcare analytics with a payer, provider, vendor, managed care , or related healthcare consulting entity + Extensive ... people with most complex and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented health care … more