- Centene Corporation (Austin, TX)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides education to members and their families on ... LMFT, or RN with BH experience is required based on state contract requirements **Preferred Experience:** * Clinical Behavioral Health and/or Case Management… more
- CenterWell (Austin, TX)
- …to the clinical team who will deliver the services requested. + Identify potential payer sources, verify benefits with payer sources (as required by department ... visits from case managers. Establish primary payers and document conversations with payer sources. + Access national or regional account information, including the… more
- TEKsystems (San Antonio, TX)
- …not typically require exercising independent judgment. Typically reports to a supervisor or manager . The Impact You'll Make in this Role As an Insurance Verification ... patient financial responsibility when applicable. * Maintain compliance with payer requirements and company policies. * Adapt to changing...Expert Level Job Type & Location This is a Contract position based out of San Antonio, TX. Pay… more
- Novo Nordisk (Houston, TX)
- …co-promotion partners. Internally, the CMCS I reports to the Portfolio District Business Manager of the specific sales territory. The CMCS I also interacts and ... basis with territory level impact + Demonstrates understanding of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer … more
- Houston Methodist (Houston, TX)
- …nationally recognized acute care indicators and criteria as approved by medical staff, payer guidelines, CMS, and other state agencies. In addition to performing the ... of care and ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as management. The URSN position… more
- Catholic Health Initiatives (Houston, TX)
- …related tools. 1. Gathers information for various financial projects, including payer contract negotiations, payment variance analysis, and reimbursement ... 1) developing/maintaining Key Performance Indicator (KPI) dashboards, reimbursement and payer mix analyses and clinic/business operational reports; 2) interpreting/explaining… more
- Amgen (Grapevine, TX)
- …of our products to medical professionals and helping them navigate the complex payer environment. We are actively searching for a Senior Specialty Representative to ... marketing strategy and promoting Amgen products as led by the District Manager . Responsibilities include: . Provide current and comprehensive knowledge of Amgen's… more
- Elevance Health (Grand Prairie, TX)
- …care improvement processes around physician, hospital and ancillary network contract negotiation strategies, utilization management efforts, new products, annual ... provider networks, claims, finance, and operations strongly preferred. + Healthcare payer experience strongly preferred. + Cost of Care knowledge and experience… more
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