- Prime Healthcare (Harlingen, TX)
- …The Analyst, Account Resolution is responsible for the timely follow-up of Managed Care /Commercial accounts. Communicates clearly and efficiently by phone with ... reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts. Qualifications EDUCATION, EXPERIENCE, TRAINING 1.… 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
- Molina Healthcare (San Antonio, TX)
- …integrity issues, and process gaps. + Applies understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape ... years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, including experience in Medicaid and/or… more
- Molina Healthcare (Dallas, TX)
- …integrity issues, and process gaps. + Apply understanding of healthcare regulations, managed care claims workflows, and provider reimbursement models to shape ... years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan setting, or equivalent combination of relevant… 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
- Molina Healthcare (Austin, TX)
- …and strong system knowledge of QNXT and other state specific applications concerning Managed Care Enrollment. + Responsible for ensuring timely reconciliation of ... education and experience **Required Experience** 5-7 years Enrollment-related experience in Managed care or Medicare setting **Preferred Education** Graduate… more
- Molina Healthcare (San Antonio, TX)
- …a high level of customer service. Previous experience in Medicare, Medicaid, and/or Managed Care is very helpful. Top notch communication skills, both written ... 2 years experience in customer service, consumer advocacy, and/or health care systems. Experience conducting intake, interviews, and/or research of consumer or… more
- Highmark Health (Austin, TX)
- …federal and state rules as well as a solid working knowledge of managed care operations, compliance program structures, information security and audit ... in leading interdepartmental and cross-functional strategy development. + Experience with managed care , Medicare and federal and/or state regulations, quality… more
- Elevance Health (Houston, TX)
- …care setting preferred. + Minimum 2 years' "telephonic" Case Management experience with a Managed Care Company preferred. + Managed Care experience ... meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic… more
- Houston Methodist (Houston, TX)
- …application of positive language principles + Knowledge of Medicare, Medicaid and Managed Care requirements + Progressive knowledge of community resources, ... of discharge planning, utilization management, case management, performance improvement and managed care reimbursement + Understanding of pre-acute and… more