- Molina Healthcare (Austin, TX)
- …guidelines. + Experience in Utilization/Quality Program management + HMO/ Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** ... and action plan, which includes strategies that ensure a high quality of patient care , ensuring that patients receive the most appropriate care at the most… more
- CVS Health (Austin, TX)
- …direct reports + 3+ years care management experience including with a managed care organization + 3+ years of experience with personal computer, keyboard ... and trainings (up to 20% travel estimated) **Preferred Qualifications** + Managed Care experience + Long Term Services and Support experience + Knowledge… more
- Houston Methodist (Houston, TX)
- …company providing utilization review services + Knowledge of Medicare, Medicaid, and Managed Care requirements + Progressive knowledge of community resources, ... + Progressive knowledge of utilization management, case management, performance improvement, and managed care reimbursement + Ability to work independently and… more
- Houston Methodist (Houston, TX)
- …Informs social worker/case manager of the patients' available benefits through insurance/ managed care provider. Assists in providing community resources/services ... to social workers and case managers, business office/patient access, etc. on insurance/ managed care benefits + Supports and assists with concurrent insurance… more
- UTMB Health (Galveston, TX)
- …knowledge of modern health care administration, principles, and practices within a managed care environment and/or an academic medical center. + Knowledge of ... Institute. The Assistant VP of SVHI assists in developing the patient care delivery system and operations across the clinical enterprise, collaborating effectively… more
- HCA Healthcare (El Paso, TX)
- …private payer regulations and processes, and possesses a thorough understanding of managed - care concepts and length-of-stay management relating to patient and ... payer regulations and processes. You will possess a thorough understanding of managed - care concepts and length-of-stay management relating to patient and… more
- HCA Healthcare (Live Oak, TX)
- …+ You will provide medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials process, ... regarding delegated utilization management and disease management operations under managed care contracts. You will meet all regulatory/contractual/accreditation… more
- CenterWell (San Antonio, TX)
- …**Required Qualifications** + A minimum of two years experience in Healthcare or managed care with Provider Contracting, Network Management or Provider Relations ... regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional… more
- Evolent (Austin, TX)
- …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... long cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers and risk-bearing organizations) + Passion… more
- Merck (Austin, TX)
- …of their current practice structure, business model, and key influencers ( Managed Care Organization/payers, employers, state policy), and their patients' ... Customer Strategy, Health Economics, Immunizations, Interpersonal Relationships, Lead Generation, Managed Care , Market Analysis, Medical Affairs, Product… more