• Senior Strategy Analyst - Medicaid (Remote)

    Highmark Health (Austin, TX)
    …Business Solutions leadership in strategic activities to expand IT capabilities for Medicaid growth in the dental market by: Applying SME knowledge to analytical ... strategic thinking to identify business needs for growing and sustaining the Medicaid business. Apply SME knowledge and oversee multiple teams' activities related to… more
    Highmark Health (10/01/25)
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  • Program Manager - Texas Directed Payment Program…

    Molina Healthcare (Fort Worth, TX)
    …accuracy and auditing configuration and outgoing payments + Focuses on process improvement , organizational change management, program management and other ... : + 3-5 years of Program and/or Project management experience. + Operational Process Improvement experience. + Healthcare experience. + Experience with Microsoft… more
    Molina Healthcare (09/07/25)
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  • Lead Analyst, Payment Integrity - REMOTE

    Molina Healthcare (San Antonio, TX)
    **Job Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan ... Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay Edits,… more
    Molina Healthcare (09/28/25)
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  • Insurance Strategy Lead

    Humana (Austin, TX)
    …of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid , and other health plans to millions. By integrating insurance with care ... role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of the company's...experience to join this team. As an Insurance Strategy Lead , you will directly contribute to high-impact strategy projects,… more
    Humana (09/17/25)
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  • Lead Enterprise AI/ML DevOps Engineer

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** As a Lead AI/ML DevOps Engineer at Humana, you will be responsible for leading the development, ... of AI/ML solutions. Additionally, you will focus on streamlining the deployment process , ensuring the scalability and reliability of AI/ML models, and monitoring… more
    Humana (07/29/25)
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  • Facility Outpatient Coder Team Lead

    HCA Healthcare (Georgetown, TX)
    …to join an organization that invests in you as a Facility Outpatient Coder Team Lead ? At Parallon, you come first. HCA Healthcare has committed up to $300 million in ... are looking for a dedicated Facility Outpatient Coder Team Lead like you to be a part of our...+ Ensures rebill requests are entered timely through the system/ process outlined in company/HSC policy + Answers coding related… more
    HCA Healthcare (09/27/25)
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  • Team Lead (AR III) Hybrid

    Methodist Health System (Dallas, TX)
    …8X5 Day (United States of America) **Job Description :** **Your Job:** The Team Lead (AR III) specializing in Professional Billing to join our team at our Central ... and the ability to foster a collaborative and innovative environment. The Team Lead will guide the team in meeting performance goals while maintaining a positive… more
    Methodist Health System (10/02/25)
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  • Director, Marketing Communication Operations

    Humana (Austin, TX)
    …Operations, you will shape strategic direction, influence senior stakeholders, and lead a high-performing team of marketers. You'll drive collaborative go-to-market ... teams and external vendors, and ensure compliance with CMS, Medicaid , and Pharmacy marketing regulations. **Key Responsibilities** **Campaign Strategy, Execution… more
    Humana (10/14/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Austin, TX)
    …the key BU's for the Organization's value-based reimbursement programs and continuous improvement models. Lead or support key strategic initiatives across ... providers enrolled in the Organization's value-based reimbursement programs and continuous improvement models. The incumbent plays different potential roles on a… more
    Highmark Health (08/20/25)
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  • Medical Director (Medicare)

    Molina Healthcare (San Antonio, TX)
    …in collaboration with the clinical lead , the medical director, and quality improvement staff. + Facilitates conformance to Medicare, Medicaid , NCQA and other ... necessity. + Participates in and maintains the integrity of the appeals process , both internally and externally. Responsible for the investigation of adverse… more
    Molina Healthcare (09/12/25)
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