- UTMB Health (Galveston, TX)
- …with commercial and government payers, including HMOs, PPOs, ACOs, and Medicaid/ Medicare Advantage plans. * Analyze reimbursement methodologies and contract ... performance to ensure profitability and operational effectiveness. * Develop and maintain strong relationships with payer representatives to facilitate contract negotiations and dispute resolution. * Collaborate with finance, legal, revenue cycle, and clinical… more
- CenterWell (Dallas, TX)
- …marketing; ideally field sales with a focus on senior value-based care models or Medicare Advantage . + In-depth knowledge of senior healthcare market dynamics. + ... Exceptional communication and interpersonal skills, with the ability to engage and build rapport with diverse stakeholders, including seniors, caregivers, and licensed agents. + Strong consultative selling skills, with a demonstrated ability to understand… more
- CenterWell (San Antonio, TX)
- …+ Knowledge of HEDIS measures and quality indicators + Experience managing Medicare Advantage panel of patients with understanding of Best Practice ... in coordinated care environment in a value-based relationship environment + Fluent in Spanish and English \#nursepractitionercareers \#physicianassistantcareers \#LI-KB2 **Scheduled Weekly Hours** 1 **Pay Range** The compensation range below reflects a good… more
- CenterWell (Austin, TX)
- …Care has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality ... primary care combined with an excellent patient experience. The LPN/LVN provides professional nursing care to patients within an assigned unit, clinic or region. The LPN/LVN assesses patient health problems and needs, takes vital signs, administers medication,… more
- TEKsystems (Dallas, TX)
- …to manage the enrollment and re-enrollment of healthcare providers across Medicare , Medicaid, and commercial insurance plans. This role ensures timely and ... and submit enrollment and re-enrollment applications for healthcare providers to Medicare , Medicaid, and commercial insurance plans. + Maintain accurate and… more
- Molina Healthcare (Austin, TX)
- …member satisfaction - CAHPS, regulatory-related, Molina Quality programs, and taking advantage of electronic solutions (EDI, EFT, EMR, Provider Portal, Provider ... various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to, fee-for… more
- TEKsystems (Dallas, TX)
- …government and non-government entities. Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance is preferable. Schedule: 8:00am-4:30pm CST - ... We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong,… more
- Sedgwick (Plano, TX)
- …of experts to both learn from and to share your insights. + Take advantage of a variety of professional development opportunities that help you perform your best ... limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests… more
- Sedgwick (Irving, TX)
- …of experts to both learn from and to share your insights. + Take advantage of a variety of professional development opportunities that help you perform your best ... deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business** Excellent… more