- Merck (Austin, TX)
- …therapeutically assigned areas + Coordinates with Outcomes Research through the USMA Payer Access Teams (PATs) to ensure team support of therapeutic aligned ... real-world evidence + Coordinates strategy, planning, and execution of scientific congress responsibilities comply with all company policies and applicable laws, regulations, and ethical standards **Education:** + Doctoral degree (MD, PharmD, PhD) with… more
- HCA Healthcare (San Antonio, TX)
- …thorough working knowledge of the rules of Medicare, Medicaid, and private payer regulations and processes. You will possess a thorough understanding of managed-care ... concepts and length-of-stay management relating to patient and organizational fiscal responsibility. + You will perform thorough assessments and develop appropriate discharge plans for high-risk patients with discharge planning or psychosocial needs. + You… more
- Elevance Health (Grand Prairie, TX)
- …design and execution of Value Based Payment Models strongly preferred + Prior Payer experience. For candidates working in person or virtually in the below ... location(s), the salary* range for this specific position is $116,256 to $199,296. Locations: Woodland Hills, CA; Denver, CO; District of Columbia (Washington, DC); Chicago, Il; Iselin, NJ; Hanover, MD; Mendota Heights, MN; Las Vegas, NV; New York City, NY;… more
- Centene Corporation (Austin, TX)
- …management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides and/or facilitates education to members and their ... families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits + Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in… more
- CVS Health (Austin, TX)
- …Relations teams. **Required Qualifications** + A minimum of 7 years of healthcare payer experience, with at least 5 years in provider operations or compliance. + ... A minimum of 2 years of experience in provider data management and contracting support. + A minimum of 3 years managing, mentoring and growing a team. + Demonstrated expertise in interpreting contracts and regulatory requirements. + Proven ability to lead… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …of experience in pharmaceutical or healthcare industries, with experience in payer and/or channel functions required + Performance tracking and quarterly business ... review development experience + Experience working in matrix management structure with project management, coordination and people management in a team environment + Proven track record in program management and cross-functional team leadership + Strong… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- …VERA funding through the Allocation Resource Center (ARC) and third-party payer requirements. Reference: For more information on this qualification standard, please ... visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-9. Education Physical Requirements: Physical aspects associated with work required of this assignment are typical for the occupation, see Duties section for… more
- Houston Methodist (Houston, TX)
- …assessment and clinical skills + Possesses knowledge of health care financial and payer issues, and eligibility for state, local and federal programs. + Embodies the ... behaviors associated with the Leadership, Art and Science of Nursing (identified in Duties and Responsibilities) at the Proficient level according to Benner's model of clinical practice + Displays professionalism, remains composed under stress, and takes… more
- Zelis (TX)
- …2+ years of experience working with healthcare claims data, preferably in a payer or analytics environment. + Strong proficiency in SQL (joins, CTEs, subqueries) is ... required. + Hands-on experience with Medicare, Medicaid, and Commercial reimbursement methodologies. + Familiarity with CPT codes, DRG, and Revenue Codes is essential. + Excellent communication skills, with the ability to explain complex data issues to… more
- Select Medical (The Woodlands, TX)
- …business development team + Collect co-pays from patients, manage payer approvals and conduct insurance authorizations and verifications **Qualifications** **Minimum ... Qualifications:** + High School Diploma/GED required + 1 Year of Medical Office Experience + Insurance Verification Experience **Preferred Qualifications:** + Bilingual + Health Care Experience **Additional Data** _Equal Opportunity Employer/including… more