- Baylor Scott & White Health (Dallas, TX)
- …+ VBC Analytics is an independent organization covering BSW Health Plan ( Payer ) and BSW Quality Alliance (ACO Provider) analytical needs. Domain verticals connect ... directly to core stakeholders and operational structures while aligning with internal SMEs and current capacities. We have over 1 million lives across multiple blocks of business and industry-leading analytics to support our organization. + We seek a… more
- Caris Life Sciences (Irving, TX)
- …and apply acquired knowledge of Medicare, Medicaid, and other Third-Party Payer requirements **Job Responsibilities** + Proficient in and exceeding job ... responsibilities of Verification/ Authorization Personnel -Specialist either through Caris or with a former employer in a similar industry. + Identify ways to improve and promote quality and monitor your own work to ensure quality standards are met. + Answers… more
- Takeda Pharmaceuticals (TX)
- …Preferred: + Experience with buy & bill product account management + Understands payer access and reimbursement at assigned regional, state, and local levels + ... Advanced business or scientific degree (MBA, MS, PharmD, etc.) + Advanced business skills in negotiation + Experience with managing and communicating complex reimbursement issues + Biological product launch experience + Experience in calling on C and D Suite… more
- R1 RCM (Austin, TX)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- HCA Healthcare (Round Rock, 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
- R1 RCM (Cedar Park, TX)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . more
- ChenMed (Houston, TX)
- …+ Prescribes medication and treatment in accordance with patient condition, payer coverage/guidelines and industry standards. + Reviews PCP requests for external ... cardiology referrals and participates in delegated utilization authorizations; determines level of urgency of follow-up, referral/consultation appointments. + May have responsibility for cardiology clinical operations of 2-4 centers in the market, under the… more
- R1 RCM (Austin, TX)
- …of the top 100 US health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare ... organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com . 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
- Highmark Health (Austin, TX)
- …data + 5 years of project leadership in a complex, matrixed environment ( payer and/or provider preferred) + 5 years of providing analytical consultation to clinical, ... administrative, operational and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Medical coding certificate… more