- Molina Healthcare (Fort Worth, TX)
- …outcomes and benefit realization + Demonstrates deep understanding of Core Operations , Claims and Enrollment processes, deliverables, vendor partners and ... productivity, quality, compliance + Articulates the goals and objectives of Molina Healthcare business units to vendors supporting operations of those units… more
- Elevance Health (Houston, TX)
- **Financial Operations Recovery Specialist Lead** **Location:** _Hybrid1:_ This role requires associates be in the office 1-2 days per week, fostering collaboration ... unless an accommodation is granted as required by law. The **Financial Operations Recovery Specialist Lead** is responsible for the discovery, validation, recovery,… more
- Molina Healthcare (Fort Worth, TX)
- …CMS timelines. 2. Workflow Integration - Embed CTM insights into downstream operations -Stars, appeals & grievances, enrollment, claims -so each team addresses ... you keep complaint data synchronized across appeals & grievances, enrollment, claims , pharmacy, and quality functions. You surface systemic issues, steer partners… more
- Houston Methodist (Houston, TX)
- …the ability to apply legal analysis to facts, offers recommendations pertaining to claims and litigation strategy, enhancing operations on a system level. + ... used + Intermediate knowledge of operational structure necessary to support optimal healthcare delivery and working knowledge of hospital operations in the… more
- Evolent (Austin, TX)
- …**What You Will Be Doing:** + **Data Analytics & Insights** : Analyze healthcare claims and authorization data to identify cost drivers, utilization trends, ... working seamlessly with diverse teams and stakeholders. + Familiarity with healthcare claims , reimbursement methodologies, and cost/utilization KPIs, including… more
- Molina Healthcare (Houston, TX)
- …managed care experience + Experience in one or more of the following: Claims , Provider Services, Provider Network Operations , Hospital or Physician Billing, or ... and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system… more
- Molina Healthcare (TX)
- …The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare, and Marketplace lines ... across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general liability, medical malpractice,… more
- Molina Healthcare (Fort Worth, TX)
- …and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system ... provider-related data and reports in support of Network Management and Operations areas of responsibility (eg, Provider Services/Provider Inquiry Research &… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- **Position Summary** The Senior Manager, Fleet & Samples Operations oversees the execution of field fleet logistics and pharmaceutical sample distribution. The role ... reliability, and compliance while collaborating closely with the Field Strategy & Operations team to meet field force needs. **Key Responsibilities** **Fleet … more
- Royal Electric (Dallas, TX)
- …We have a current opening for a Project Manager with Healthcare project experience in Dallas, TX. The Healthcare Project ... team thoroughly understands project. + Facilitate coordination between Field Operations and Preconstruction (preplanning, prefabrication) and actively engage in… more