• Health Plan Operations

    Molina Healthcare (Dallas, TX)
    **Job Description** **Job Summary** The Health Plan Operations , Payment Integrity Program Manager is an individual contributor role designed for a highly ... capable individual who serves as a key strategic partner in driving health plan financial performance. This role focuses on identifying, leading, and executing… more
    Molina Healthcare (08/14/25)
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  • VP Coverage Network

    Baylor Scott & White Health (Dallas, TX)
    …various third-party administrator (TPA) platforms. The leader will collaborate regularly with Health Plan operations on network configuration, provider data ... to Employer (DTE)/Employer Solutions strategy - Partners closely with the health plan operations Provider Data Integrity Unit (pricing, configuration,… more
    Baylor Scott & White Health (08/29/25)
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  • Strategic Account Executive

    Wondr Health (Austin, TX)
    …partnership experience. **KNOWLEDGE, SKILLS, AND ABILITIES** **:** + Deep understanding of health plan operations , reimbursement models, and regulatory ... **POSITION:** **Stra** **tegic Account Executive** **REPORTS TO:** **SVP, Client and Health Plan Success** **SUPERVISES:** **None** **JOB CLASS:** **Exempt**… more
    Wondr Health (09/03/25)
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  • Director Reimbursement Design & Market Evaluation

    Highmark Health (Austin, TX)
    …and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations . **ESSENTIAL RESPONSIBILITIES** + Perform management ... business. This will require aligning new models to the health plan 's strategic objectives based on a...Plan , organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and… more
    Highmark Health (07/30/25)
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  • Manager, Enrollment - REMOTE

    Molina Healthcare (Austin, TX)
    …point of contact for the internal partners, ie Medicare Administration, Compliance and Health Plan Operations . Coordinates and facilitates meetings providing ... processing and maintenance of new members and re-enrollment. Processes and maintains health plan 's member and enrollment records, employer's monthly reports,… more
    Molina Healthcare (08/01/25)
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  • Vice President, Strategic Accounts

    Evolent (Austin, TX)
    …transformative growth opportunities at customer accounts + Strong knowledge of health plan operations , care/utilization management, claims processing, ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health more
    Evolent (08/27/25)
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  • Manager, HCS Operations Support

    Molina Healthcare (TX)
    …Experience** * Min. 5 years operations or administrative experience in healthcare/ health plan industry, including 1+ years as a supervisor. * Strong ... Degree **Preferred Experience** 3+ years of healthcare or health plan supervisory experience. Managed Care operations experience. Prior Medical Assistant… more
    Molina Healthcare (08/16/25)
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  • Director, Medicare Duals Optimization (Remote)

    Molina Healthcare (San Antonio, TX)
    …10 years' experience in Managed Care, specifically government programs and/or Medicare/Duals Health Plan Operations or equivalent combination of education ... program. Supports integrated duals product development in collaboration with enterprise and health plan teams. Supports integrated teams in continual process… more
    Molina Healthcare (08/22/25)
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  • Senior Process Consultant (Medicare) - REMOTE

    Molina Healthcare (Houston, TX)
    …Education** Graduate Degree **Preferred Experience** + 4 years' experience in healthcare and/or health plan operations + Project management 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.… more
    Molina Healthcare (07/19/25)
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  • VP Pharmacy - Health Plan

    Baylor Scott & White Health (Temple, TX)
    Health Plan (HP) oversees planning, directing, and coordinating pharmacy operations at Baylor Scott & White Health (BSWH). This includes selecting and ... packaging, and dispensing of drugs and therapeutics for BSWH Health Plan pharmacy. Plans and directs pharmacy...+ Drives the development and implementation of a strategic plan for pharmacy operations . This includes an… more
    Baylor Scott & White Health (06/22/25)
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