• Director, Revenue Cycle Payer Performance

    Baylor Scott & White Health (Dallas, TX)
    …This role serves as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline payer communications. The Director ... a matrixed organizational structure, collaborating closely with teams across Revenue Cycle, Managed Care , Finance, and Operations. **Essential Functions of the… more
    Baylor Scott & White Health (09/04/25)
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  • Behavioral Health Care Manager II

    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:...is designed to advance our strategy but will also lead to personal and professional growth for our associates.… more
    Elevance Health (09/26/25)
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  • Medical Director

    Health Care Service Corporation (Richardson, TX)
    …for electronic documentation of case reviews PREFERRED REQUIREMENTS: + 3 years Managed Care experience + Physical medicine and rehab, Anesthesiologist, plastic ... our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an...decisions for themselves and their families. As an industry leader , HCSC also has been helping to make the… more
    Health Care Service Corporation (10/08/25)
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  • Provider Service Analyst

    Health Care Service Corporation (Richardson, TX)
    …plus 1 year of data analytics/analysis experience OR 3 years' experience in managed care products, programs, or services. + Leadership experience. + Knowledge ... our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an...decisions for themselves and their families. As an industry leader , HCSC also has been helping to make the… more
    Health Care Service Corporation (10/08/25)
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  • Delegation Oversight Coordinator Credentialing

    Health Care Service Corporation (Richardson, TX)
    …+ Associate Degree in Business or Medical OR 3 or more years' experience in a managed care environment. + 2 years in a leadership role that includes direct ... our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an...decisions for themselves and their families. As an industry leader , HCSC also has been helping to make the… more
    Health Care Service Corporation (10/08/25)
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  • Early Careers - Audit Specialist Intern

    Health Care Service Corporation (Richardson, TX)
    …coding schemes, system applications, COB procedures, pricing and provider files, and managed care principles and develop and maintain rapport with internal ... our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an...decisions for themselves and their families. As an industry leader , HCSC also has been helping to make the… more
    Health Care Service Corporation (10/08/25)
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  • VP, Ltss - Health Care Operations (Remote)

    Molina Healthcare (Austin, TX)
    …Nurse (APRN), etc.). + Experience leading a line of business or product line in managed health care . To all current Molina employees: If you are interested in ... Contributes to overarching strategy to provide quality and cost-effective member care . **ESSENTIAL JOB DUTIES:** + Supports executive strategy development, vision… more
    Molina Healthcare (09/25/25)
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  • Pharmacist - Clinical Advisor

    CVS Health (TX)
    …of the time as required to meet business needs. **Required Qualifications** 3+ years of managed care Pharmacist experience and/or 1 year of Managed Care ... in good standing. - Demonstrated experience in a client-facing role within the managed care environment - Demonstrated understanding of and experience with… more
    CVS Health (10/08/25)
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  • Sr Utilization Review Specialist Nurse

    Houston Methodist (Houston, TX)
    …staff in communicating medical information required by external review entities, managed care contractors, insurers, fiscal intermediaries, state, and federal ... and application of positive language principles + Knowledge of Medicare, Medicaid, and Managed Care requirements + Knowledge of community resources, health … more
    Houston Methodist (08/26/25)
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  • Lead Analyst, Payment Integrity - REMOTE

    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 ... **Job Description** **Job Summary** Provides lead level support as a highly capable business...as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health plan… more
    Molina Healthcare (09/28/25)
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