- Molina Healthcare (Dallas, TX)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Knowledge of integrated… more
- Molina Healthcare (Austin, TX)
- …who reside anywhere in Texas; applicants who have previous experience working as a case manager within a managed care organization (MCO) like Molina are ... Office suite/applicable software program(s) proficiency. **PREFERRED QUALIFICATIONS:** * Certified Case Manager (CCM). * Experience in behavioral health care … more
- US Physical Therapy (Houston, TX)
- …within closed networks + Interprets managed care contracts and government reimbursement methodologies to create contract modeling calculation. ... a positive attitude to join our company as a ** Contract Manager /Analyst.** This is a dual role...This is a dual role that will support the ** Managed Care Operations Team** . The person… more
- Elevance Health (Grand Prairie, TX)
- …or related field and a minimum of 7 years experience in broad-based analytical, managed care payor or provider environment as well as in depth experience ... **Provider Contract Cost of Care Consult Senior...end results. + Works side by side with their manager . **Minimum Requirements:** Requires BA/BS degree in Mathematics, Statistics… more
- Elevance Health (Grand Prairie, TX)
- …or related field and a minimum of 3 years experience in broad-based analytical, managed care payor or provider environment as well as experience in statistical ... **Provider Contract Cost of Care Analyst Senior**...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Houston Methodist (Houston, TX)
- …services by communicating medical information required by all external review entities, managed care contracts , insurers, fiscal intermediaries, state, and ... At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse...language principles + Comprehensive knowledge of Medicare, Medicaid and Managed Care requirements + Comprehensive knowledge of… more
- CVS Health (TX)
- …executing national, regional, or market level strategies. * In-depth knowledge of the managed care industry and practices, as well as a strong understanding ... to Aetna's established policies. * Responsible for auditing, building, and loading contracts , agreements, amendments and/or fee schedules in contract management… more
- Prime Therapeutics (Austin, TX)
- …experience in clinical operations, quality, network, pharmacy or project management OR a managed care pharmacy residency. + Proven ability to plan, organize, ... Manages financial aspects of account(s). + Ensures revenue goals are met, cost of care and administrative expenses managed , and EBIDTA targets achieved for the… more
- Xcel Energy (Lubbock, TX)
- …and development activities to ensure category strategy adherence. Develop and execute contracts with key suppliers. This position is responsible for managing the ... staff augmentation managed service providers used by Xcel Energy with budgetary...practices. Collaborate with business stakeholders to align business demands, category/ contract strategy, and execution. Perform spend and cost analysis… more
- Elevance Health (Grand Prairie, TX)
- …in the United States** . Licensure is a requirement for this position. + Prior managed care experience required. For candidates working in person or virtually in ... depression, and insightful analytics to improve the delivery of care . **Behavioral Health Care Mgr II** Location:...effective setting in accordance with UM Clinical Guidelines and contract . + Refers cases to Peer Reviewers as appropriate.… more