- Molina Healthcare (Houston, TX)
- …Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. Essential Job ... of pharmacy prior authorization requests and/or appeals. * Explains point-of-sale claims adjudication, state, NCQA and CMS policies/guidelines, and any other… more
- Molina Healthcare (Austin, TX)
- …Medicare/MMP. + Analysis and reporting related to Managed care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS ... focus. + Develop oneself as HEDIS subject matter expert to help health plan improve performance on underperforming measures. **Job Qualifications** **REQU** **I**… more
- Mass Markets (TX)
- …Management Define and track KPIs to measure sales effectiveness, pipeline health , and revenue performance. + Cross-Functional Collaboration Work closely with ... ranging from electronics to dream vacations and sometimes even cars! + Health Benefits:Full-time employees are eligible for comprehensive medical, dental, and vision… more
- GE Vernova (TX)
- …resource leader will manage a team of GE resources and contractors that execute warranty claims and services orders in NAM. In this role you will be utilize your ... performance in all areas including cost, schedule, technical advisory services, Environmental Health & Safety (EHS) and quality . Identify performance issues and… more
- Rent the Runway (Arlington, TX)
- …into HR tracker and submit for processing. + Process worker compensation claims timely and accurately to ensure compliance. + Handle all pre-hire requirements ... the runway (and give us valued feedback!). + Comprehensive health , vision, dental, FSA and dependent care from day...dependent care from day 1 of employment - Your health comes first and we've got you covered. +… more
- Mass Markets (TX)
- …Performance Management Establish and monitor KPIs to measure team effectiveness, pipeline health , and revenue outcomes. + Budget Oversight & ROI Optimization Manage ... ranging from electronics to dream vacations and sometimes even cars! + Health Benefits:Full-time employees are eligible for comprehensive medical, dental, and vision… more
- ADP (El Paso, TX)
- …to support client benefits administration, resolve eligiblity, vendor invoicing and claims issues. + Coordinates with back office the audits, reconciliation and ... QA, transaction processing + Provides service support related to the administration of health - welfare benefit programs to the client and internal business partners… more
- System One (Austin, TX)
- …and coordinate technical support. + Oversee contract compliance, change orders, and claims management as needed. Quality, Safety & Compliance + Ensure adherence to ... a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts,… more
- TEKsystems (Houston, TX)
- …partners to ensure seamless healthcare experiences. with a strong understanding of our health plans and benefit offerings in order to resolve complex coverage and ... Leveraging strong customer service and de-escalation skills to properly manage complex claims issues and support our members through difficult situations. Top Skills… more
- Sunrise Senior Living (Frisco, TX)
- …internal business controls. + Process and manage unemployment and worker's compensation claims and update claim activity as necessary. + Clearly communicate and ... community is in compliance with national/provincial regulations pertaining to occupational health and safety and promoting Risk Management programs and policies and… more