- Highmark Health (Austin, TX)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... and servicing quality dental networks in assigned territory in a remote and mobile work environment. Manage network contracts including negotiations, contract… more
- Humana (Austin, TX)
- … claims , and customer service). + Collaborate with each Insurance Operations function to identify, understand, and align Stars-related business strategies, ... + 8-9 + years of quality improvement, developing & advancing enterprise strategy, insurance operations experience, ie: claims , UM, CM, call center, enrollment,… more
- CVS Health (Austin, TX)
- At CVS Health , we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming ... health care. As the nation's leading health ...Proposal_ ) questionnaire responses, and plan consultation. This fully remote position will have the opportunity to work on… more
- Highmark Health (Austin, TX)
- …all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the ... rates utilizing Company rating algorithms, adjusting accordingly to cover questionable claim patterns or unusual situations not otherwise contemplated within the… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy, ... data transformations, automation, and enhancements. Conduct in-depth analysis of healthcare claims to identify data issues and optimization opportunities. Work with… more
- The Hartford (TX)
- …- LM07DE We're determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every ... do. The Senior Staff Attorney is an in-house, fully remote , position that will handle a designated caseload of...business environment where you will have direct interaction with Claim partners and insureds, we want to speak with… more
- Covr Financial Technologies (Houston, TX)
- Case Manager, Life Insurance REPORTS TO: Team Lead, Case Management DEPARTMENT: Insurance Operations FLSA STATUS: Exempt TRAVEL: None WORK SCHEDULE: M-F, subject ... to business needs LOCATION: Houston, Texas (hybrid - 4 days onsite/1 days remote ) COMPANY OVERVIEW: Covr Technologies is a market leading insurance -as-a-services… more
- Molina Healthcare (Fort Worth, TX)
- …least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant ... in areas to ensure alignment to regulatory baseline requirements and any health plan/product team developed requirements. + Monitors regulatory sources to ensure all… more
- Health Care Service Corporation (Richardson, TX)
- …needs of a specific domain for supplier management services. Customer service, IT, health care management or data and analytics solutions of the supplier management ... analytical and collaboration skills. **Preferred Job Qualifications:** + Knowledge of HCSC claim systems + Knowledge of HCSC Payment Integrity Offerings + Knowledge… more
- CVS Health (Austin, TX)
- …consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care resources. **This is a remote based (work at home) ... At CVS Health , we're building a world of health...will be responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise **Required… more