- Molina Healthcare (Houston, TX)
- …Project management experience. + Operational Process Improvement experience. + Healthcare experience. + Experience with Microsoft Project and Visio. + Excellent ... system analysis and program staff. These positions' primary focus is project/program management . **Job Duties** + Lead system and process solution initiatives from… more
- CVS Health (Austin, TX)
- …of claim coding (CPT/DRG, etc.), provider networks, benefit designs, healthcare products/funding, medical management programs and financial acumen. - ... day. **Position Summary** We are searching for an experienced provider network professional to support our plan...unique opportunity to work directly with plan sponsors, account management , local/ national network , clinicians and analysts… more
- Prime Therapeutics (Austin, TX)
- …+ 8 years of Network Management experience within Pharmacy Benefit Management (PBM), healthcare or other highly regulated industry; including 5 years of ... that. It fuels our passion and drives every decision we make. **Job Posting Title** Network Management Consultant - Remote **Job Description** The Network … more
- Ascension Health (Waco, TX)
- …of the offer._ **Responsibilities** Ascension Providence is looking for an Advanced Practice Provider for our Pain Management Clinic. This is a great opportunity ... **Details** + **Specialty:** Pain Management + **Schedule:** M-F | 8a-5p + **Call...for the right candidate to provide medical services to patients at Ascension Providence located… more
- The Cigna Group (Fort Worth, TX)
- …related + **2+ years of Healthcare Insurance experience required, preferably within Provider Network , Provider Contracting, Provider Data** + ... plays a key role in ensuring the accuracy, completeness, and timeliness of provider network data required for regulatory approval and compliance. **Primary… more
- Evolent (Austin, TX)
- …Account teams and payer clients to align priorities and deliver high-quality provider network engagement, performance reporting, and present to health plans ... advisory panels + Own market level engagement strategy and collaborate with provider engagement market managers to ensure change management initiatives are… more
- Molina Healthcare (Houston, TX)
- …system requirements of customers as it pertains to contracting (benefit and provider ), network management , credentialing, prior authorizations, fee ... business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit interpretation within the audit… more
- Elevance Health (Houston, TX)
- …impact on the quality-of-service delivery. + Research issues that may impact future provider contract negotiations or jeopardize network retention. + Travels to ... 2 years of customer service experience including 1 year of experience in a healthcare or provider environment; or any combination of education and experience,… more
- CVS Health (Austin, TX)
- …reside anywhere in the US.** **Requirements** + Responsible for out of network (cost management ) products, savings, revenue, financial results and commitments. ... and continuous learning. **Background/Experience** **Required** + Minimum 8 years in healthcare industry experience in product, finance, operations, network /out… more
- CVS Health (Austin, TX)
- …support audit readiness and collaborates with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure alignment with ... also serve as a key liaison between Compliance, Legal, Network Contracting, and Provider Relations teams. **Required...+ A minimum of 2 years of experience in provider data management and contracting support. +… more