• Lead Director, Product Mgt & Development…

    CVS Health (TX)
    …open to qualified candidates within the United States. **Required Qualifications** 10+ years of Managed Care experience in health plan and/or PBM roles 10+ years ... CMS audit experience HPMS experience **Preferred Qualifications** 15+ years of Managed Care experience in health plan and/or PBM roles 15+ years Medicare… more
    CVS Health (09/23/25)
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  • Medicaid State Technology Lead

    Humana (Austin, TX)
    …policy administration or related field;work experience may meet this need + 5 + years managed care experience + 5 + years in Medicaid program implementation or ... and clinical operations; Medicaid preferred + Comprehensive understanding of a Medicaid Managed Care architecture, tools, utilities and processes utilized to… more
    Humana (09/03/25)
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  • Case Manager (RN) | Case Management & Social Work

    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
    Houston Methodist (08/30/25)
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  • Medical Director (AZ)

    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
    Molina Healthcare (09/26/25)
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  • Center Administrator

    CenterWell (Fort Worth, TX)
    …Knowledge of and experience working with Provider Communities. + Medicare knowledge + Managed care experience + Proven ability to function effectively in matrix ... knowledge. + Direct leadership experience and demonstrated ability to lead , coach and mentor teams. + Proven interpersonal skills...of an interdisciplinary team. + Solid understanding of medical care delivery, managed care financial… more
    CenterWell (09/16/25)
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  • Vice President, Growth - Payer

    Evolent (Austin, TX)
    …and proficiency + Personally initiate and foster executive level relationships at managed care organizations or health systems and large provider groups ... **:** The **VP,** **Growth** **-** **Pay** **e** **r** will lead strategic partnerships with health plans. + Develop and...cycles requiring diverse stakeholder management + Knowledge of the managed care and provider markets (both payers… more
    Evolent (09/15/25)
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  • Lead Analyst, Quality Analytics…

    Molina Healthcare (Austin, TX)
    …for Medicaid, Marketplace and Medicare/MMP * Develops custom health plan reports related to managed care data like Medical Claims, Pharmacy, Lab and HEDIS rates ... **Job Summary** The Lead Analyst, Quality Analytics and Performance Improvement role...cleaning of data. * 5+ Years of experience in Managed Care Organization executing similar techno functional… more
    Molina Healthcare (08/17/25)
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  • Area Business Director - Portfolio

    Sanofi Group (Dallas, TX)
    …functional areas of the business (eg Sales Training, Customer Solutions, Sales Operations, Managed Care and Marketing) **Why Choose Us?** + Bring the miracles ... a full portfolio of vaccines, strengthen customer relationships, and lead a high performing sales team? We are responsible...care or vaccine products + Knowledge of the managed market dynamics and competitive landscape in the acute… more
    Sanofi Group (09/19/25)
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  • Clinical Advisor

    Humana (Austin, TX)
    …+ Advanced Degree (such as MSN, MBA, MHA, MPH). + Experience in managed care , health plan operations, or Medicare Advantage programs (including various ... initiatives, including root cause analysis, best practices to close care gaps. **Use your skills to make an impact**...to internal and external stakeholders. + Demonstrated ability to lead through influence and collaborate across teams. + Thrive… more
    Humana (10/07/25)
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  • Deputy General Counsel, Litigation - REMOTE

    Prime Therapeutics (Austin, TX)
    …work experience, including 12 years of experience as an attorney and 5 years representing managed care companies, health care clients, or clients in highly ... member of the legal department's leadership team. **Responsibilities** + Lead and mentor a team of attorneys and support...False Claims Act, with a focus on PBM and managed care operations + Experience engaging with… more
    Prime Therapeutics (07/19/25)
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