• Medical Director - Florida

    Humana (Austin, TX)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized. All work occurs… more
    Humana (10/03/25)
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  • Medical Director-Payment Integrity

    Humana (Austin, TX)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... and judgement to make determinations whether requested services, requested level of care , and/or requested site of service should be authorized at the Inpatient… more
    Humana (09/26/25)
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  • Medical Director - Mid West Region

    Humana (Austin, TX)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... 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
    Humana (09/16/25)
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  • Medical Director - Northeast Region

    Humana (Austin, TX)
    …services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed ... + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an… more
    Humana (07/25/25)
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  • Director, Provider Contracts (Must reside…

    Molina Healthcare (Houston, TX)
    …SKILLS & ABILITIES** : * 7+ years experience in Healthcare Administration, Managed Care , Provider Contracting and/or Provider Services, including 2+ years ... with other operational departments and functional business unit stakeholders to lead or support various Provider Contracting functions. This role primarily leads… more
    Molina Healthcare (10/05/25)
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  • System Manager Revenue Cycle (Medicare Hospital…

    Houston Methodist (Katy, TX)
    …competency and professional pathway progression. + Communicates updates/changes to processes, managed care information, throughput, etc., in a timely manner. ... government regulations. + **Audit Oversight & Lifecycle Management** + Lead the management and response process for a variety...after ongoing revenue cycle analysis. Meets with payors and/or Managed Care to discuss aged accounts, adjudications… more
    Houston Methodist (08/13/25)
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  • Senior Contract Administrator - Revenue Cycle Ops…

    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,...(MBA) or Health Administration (MHA). **ESSENTIAL JOB FUNCTIONS** * Lead the development, negotiation, and management of contracts with… more
    UTMB Health (08/08/25)
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  • Clinical Business Lead

    Humana (Austin, TX)
    …+ Advanced Degree (such as MSN, MBA, MHA, MPH). + Experience in managed care , health plan operations, or Medicare Advantage programs (including various ... part of our caring community and help us put health first** **Clinical Business Lead , Humana Medicare Advantage** As Regional Clinical Business Lead , you serve… more
    Humana (10/01/25)
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  • Medical Staff Credentialing Specialist

    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 ... and experience is required + Three years of Credentialing experience in a managed care plan, medical staff services office or credentialing verification office… more
    Texas Tech University Health Sciences Center - El Paso (09/30/25)
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  • Chief Medical Officer

    HCA Healthcare (San Antonio, TX)
    …contracting issues. + Provides medical consultation on contracting, pricing, and analysis of managed care issues. Offers clinical support for appeals and denials ... regarding delegated utilization management and disease management operations under managed care contracts. Meets all regulatory/contractual/accreditation requirements… more
    HCA Healthcare (09/20/25)
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