- Highmark Health (Austin, TX)
- …translate business needs into scalable and efficient solutions within the Payer and Provider space. Responsibilities include delivering solutions for Salesforce ... Marketing Cloud projects, ensuring alignment with business objectives and best practices; gathering and translating business requirements into technical specifications; providing expertise on Salesforce capabilities and best practices; designing and input to… more
- Boehringer Ingelheim (San Antonio, TX)
- …plans for customers. + Engages customers in comprehensive discussions on the payer environment, Co-pays, formulary access and BIPI patient adherence tools. + Works ... in collaboration with local sales leadership, payor sales to generate and sustain support for products on MCO formularies, including AIM priorities. + Delivers on continuation of care model, including discharge protocol, treatment algorithms, disease… more
- University of Texas Rio Grande Valley (Rio Grande, TX)
- …medical information. Coordinates clinical services provided to patients according to payer guidelines (eg, routing of lab specimens, ordering durable medical ... equipment). + Help maintain an acceptable abandonment (no show) rates. + Perform a variety of clinic specific telephone functions including scheduling and message management. + May be required to provide coverage at other clinical sites as needed. + Performs… more
- Cognizant (Austin, TX)
- …House:** TriZetto offers product solutions to the healthcare industry from streamlining payer processes to automating insurance operations. The practice has its own ... ecosystem of businesses including positions in marketing, project management, and technical roles - such as developers and analysts. **Products include:** + Clinical CareAdvance and CareAdvance Provider + EngageMember + EngageProvider + Facets + NetWorX… more
- Evolent (Austin, TX)
- …years of professional experience in claims-based healthcare analytics with a payer , provider, clinical vendor, managed care, or related healthcare consulting entity ... + Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs + Exceptionally strong analytical abilities, with track record of identifying and communicating insights from… more
- Baylor Scott & White Health (Dallas, TX)
- …assigned areas. Prepares the 5-year financial operating forecast to include statistics, payer mix, payments capital, etc. Prepares analysis and presents and defends ... findings, for any potential capital acquisitions, projects, new services, etc. Provides ongoing budget vs. actual revenue and expense variance analysis through review of both standard reports and reports which have been developed specifically for the entity.… more
- HCA Healthcare (Austin, TX)
- …performance driven, incentive plan driven, customer needs, identified trends, RAC, payer , etc.) for inpatient and/or outpatient coding (eg, DRG/code validation, ... query validation) + Provides timely feedback and education as it relates to coding opportunities found during the review of accounts + Ensures rebill requests are entered timely through the system/process outlined in company/HSC policy + Answers coding related… more
- HCA Healthcare (Pasadena, 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
- Drips (TX)
- …sales motions and 4 - 6+ month cycles. + Deep understanding of payer market dynamics, complexities, and decision-making structures who can advise clients with ... expertise. + Command and executive presence with the ability to lead strategic conversations SVP decision-makers. + Embraces and contributes to high-performance culture, grounded in team collaboration, discipline, accountability, integrity, and a high drive. +… more
- Conduent (Dallas, TX)
- …Payment Integrity Solutions performs in depth pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide ... variety of pharmacy records against our client's pharmacy claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be required to represent our clients and conduct "on-site" pharmacy audits. **Responsibilities** +… more