- Humana (Austin, TX)
- …on average) Eastern Time Zone hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid ... experience, and judgement to make determinations whether requested services, level of care , and/or site of service should be authorized. All work occurs within… more
- Highmark Health (Austin, TX)
- …Doctor of Pharmacy degree + Active pharmacist license + 4 years of experience in managed care pharmacy + 2 years of clinical account management experience in ... Medicare as part of the 4 year managed care experience + 2 years of experience analyzing pharmaceutical cost of care data **Substitutions** + None… more
- Humana (Austin, TX)
- …while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement ... - Medicaid health plan. The individual leverages a broad understanding of managed care and pharmacy benefit management (PBM) to develop and implement strategies… more
- Houston Methodist (Katy, TX)
- …competency and professional pathway progression. + Communicates updates/changes to processes, managed care information, throughput, etc., in a timely manner. ... projects after ongoing revenue cycle analysis. Meets with payors and/or Managed Care to discuss aged accounts, adjudications timeframes, and erroneous denials. +… more
- University of Texas Rio Grande Valley (Edinburg, TX)
- …financial planning, revenue cycle management, budgeting, financial reporting, oversight of managed care contracts, and to ensure compliance with regulatory ... * Manages relationships and negotiations with payers; evaluates, negotiates, and administers managed care contracts. * Ensures the development and monitoring of… more
- Fresenius Medical Center (Irving, TX)
- …with management and executives to determine appropriate plan of action. Supports Managed Care staff in budgeting and forecasting activities. PRINCIPAL DUTIES ... + Responsible for timely and accurate communication of revenue reporting to Managed Care Management Team. + Responsible for compliance with all related data… more
- UTMB Health (Huntsville, TX)
- …States** Social Service UTMB Health Requisition # 2506596 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... of the Program Manager for Assistive Disability Services for UTMB Correctional Managed Care . **_ESSENTIAL JOB FUNCTIONS_** + Contributes to the success… more
- Prime Healthcare (Harlingen, TX)
- …Responsibilities The Analyst, Billing is responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone ... and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications Education and Work Experience +… more
- UTMB Health (Galveston, TX)
- …Health Requisition # 2504255 **JOB SUMMARY** The primary responsibility of the Managed Care , Senior Contract Administrator position is leading, developing, and ... negotiating managed care agreements to ensure favorable reimbursement, alignment with organizational goals, and compliance with federal and state regulations.… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …Paso **Preferred Qualifications:** + Three years of Credentialing experience in a managed care plan, medical staff services office or credentialing verification ... is required + Three years of Credentialing experience in a managed care plan, medical staff services office or credentialing verification office **Does… more