- Centene Corporation (Austin, TX)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- CVS Health (Austin, TX)
- …you will create connections with our customers by helping with their benefits and claims to improve their health and well-being. You will be responsible for ... At CVS Health , we're building a world of health...educating customers about their benefits and claims while resolving issues and directing them to helpful… more
- CVS Health (Austin, TX)
- …licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another Health Plan / Payor or Hospital ... At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming … more
- Apex Health Solutions (Houston, TX)
- …requires a licensed Certified Public Accountant (CPA) with proven experience in health plan finance, including premium revenue, claims reserves, medical loss ... and variance analyses. Ensure compliance with federal and state health plan regulations (eg, CMS, NAIC, TDI, DOI) and...including at least 5 years in a leadership role. Health plan or managed care industry experience preferred (eg,… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- Elevance Health (Grand Prairie, TX)
- **Senior Health Economist - Managed Care** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... not eligible for current or future visa sponsorship._ Carelon Health is a proud member of the Elevance ...Senior) measures financial performance of core Carelon products leveraging claims , authorization, and membership data to tell a detailed… more
- UTMB Health (Galveston, TX)
- …Texas, United States** **New** **Hot** Business, Managerial & Finance UTMB Health Requisition # 2506574 **Minimum Qualifications:** High School Diploma or ... Specialist will be responsible for billing all third party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital … more
- UTMB Health (Galveston, TX)
- …Follow Up **Galveston, Texas, United States** Business, Managerial & Finance UTMB Health Requisition # 2506226 **Minimum Qualifications** : High School Diploma or ... Specialist will be responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital … more
- Texas Health Resources (Arlington, TX)
- Pricing Analysts - Texas Health Resources _Bring your passion to Texas Health so we are Better + Together_ Work Location: Texas Health Corporate, 612 E. ... Do: Strategic Pricing and Modeling: Analyze pricing for hospitals, behavioral health , long term acute care hospital, ambulatory surgery centers, imaging centers,… more
- Ascension Health (Austin, TX)
- …4910 Mueller Blvd Austin, Texas **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans ... account record of all billing activities. Maintain documentation of claims processed as part of the daily claims...will love. Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and… more