- Fresenius Medical Center (Dallas, TX)
- … programs (HMOs, PPOs, POS, etc). Oversees Division's contractual relationships with managed care organizations and other third party payors regarding rate ... financial effect, cost benefit and utilization. + Negotiates contractual relationships with managed care organizations and other third party payors as needed.… more
- Sedgwick (Dallas, TX)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Managed Care Client Service Director (REMOTE) Are you looking for an ... path. + Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs....including two (2) years in a supervisory capacity. **TAKING CARE OF YOU** + Flexible work schedule. + Referral… more
- Molina Healthcare (Dallas, TX)
- …including clinical practice in behavioral health and at least 3 years as a medical director in a managed care setting supporting utilization management and ... programs, utilization management standardization, and cost-effective quality outcomes in a managed care environment. Contributes to overarching strategy to… more
- AbbVie (Dallas, TX)
- …across the Surgical/Interventional Glaucoma sector, geography and franchise(s), including Key Managed Care and Payer dynamics. Share and provide quantitative ... pharmaceutical, medical, and surgical industry experiences such as physician/account-based selling, training, managed health care and marketing. + Ability to set… more
- Texas Health Resources (Arlington, TX)
- Director Care Transition _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like ... techniques such as Six Sigma, Lean, and Clinical Microsystems. Knowledge of managed care contracting and standards, medical necessity, and precertification… more
- Health Care Service Corporation (Richardson, TX)
- …**:** + Bachelor's degree OR 4 years' experience in selling or account management of managed care products. + Current, valid State Agent Insurance License. + 8 ... years' experience in managed care insurance sales. + 3 years of management experience in a managed care environment in account management or sales. +… more
- Baylor Scott & White Health (Dallas, TX)
- …denials. This role serves as a critical liaison between Revenue Cycle leadership and Managed Care leadership to support and streamline payer communications. The ... a matrixed organizational structure, collaborating closely with teams across Revenue Cycle, Managed Care , Finance, and Operations. **Essential Functions of the… more
- Health Care Service Corporation (Richardson, TX)
- …and/or MBA. + Quality experience and Medical Management experience in a leading managed care /insurance or provider organization. + Health Informatics Training + ... consistent with HCSC goals, regulatory requirements, and accreditation. The senior director will remain current with best practices and innovations in the… more
- Health Care Service Corporation (Richardson, TX)
- …Pharm D Pharmacist in the state of operations. * At least 4 years experience in managed care pharmaceuticals. * At least 4 years of managerial experience in the ... Therapy Management program within HCSC's integrated Enterprise Pharmacy. The Senior Director will support HCSC's Medical and Pharmacy Benefit Integration, MTM, PBM,… more
- Health Care Service Corporation (Richardson, TX)
- …Oncology, Physical Medicine and Rehabilitation, Surgical, Plastic Surgeon, or + 3 years Managed Care experience This is a Telecommute (Remote) role: Must reside ... at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to… more
- CVS Health (Irving, TX)
- …success in driving sophisticated contract negotiations and completion of contracts, PBM and managed care expertise, with a focus on the management of pharmacy ... your next role?! In this high impact role as Director of Trade Relations - Contract Negotiator, you will...Qualifications:** -10+ years of professional work experience in healthcare, managed care , health plans, or PBM, preferably… more
- Baylor Scott & White Health (Dallas, TX)
- …for overseeing the enrollment of BSWH facilities and providers with government and managed care payers, ensuring all processes comply with regulatory and payer ... **Job Summary** The Director , Provider Enrollment, is responsible for the strategic...payer enrollments and claims submission. Collaborates with Legal, Compliance, Managed Care , Medical Staff Services, Government Finance,… more
- Molina Healthcare (Dallas, TX)
- …experience in transformation, strategy, enterprise project or change management within a managed care or healthcare organization, or equivalent combination of ... teams through large-scale change and implementation efforts. + Deep understanding of managed care operations, provider networks, and healthcare delivery systems.… more
- S&P Global (Dallas, TX)
- …Role:** **Grade Level (for internal use):** 12 **About the Role:** **Associate Director , Fixed Income Index Calculation and Distribution** **The Team:** The Fixed ... of accuracy and integrity. Collaborating with cross-functional teams, the Associate Director will ensure calculation inputs are validated, oversee calculations and… more
- Prominence Advisors (Dallas, TX)
- Prominence Advisors is actively seeking a Director of Analytics to join their team. Director of Analytics provides leadership for all activities related to Data ... and activities to ensure projects are prioritized and properly managed . This includes managing project timelines, budgets, resource forecasting...at their fingertips in order to deliver higher quality care at a lower cost. Ranked as a best… more
- WTW (Dallas, TX)
- …organization, health benefits consulting or brokerage environment, health insurance carrier, managed care organization or another leading health care ... **Description** As a Health Analytics Director you will partner with other Senior Consultants...coverage), Dental, Vision, Health Savings Account, Commuter Account, Health Care and Dependent Care Flexible Spending Accounts,… more
- Molina Healthcare (Dallas, TX)
- …equivalent experience. **Required Experience** At least 7 - 10 years of experience in Managed Care and/or health plan quality. Clinical experience is needed for ... **JOB DESCRIPTION** **Job Summary** Regional Director Risk & Quality Solutions is responsible for...focused on Accreditation, Compliance, HEDIS Interventions, Potential Quality of Care issues, and medical record abstraction. Technical and strategy… more
- Molina Healthcare (Dallas, TX)
- …new programs. Preferred Qualifications * Experience with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified ... for both members and providers and ensuring members receive the most appropriate care in the most effective setting. Contributes to overarching strategy to provide… more
- Molina Healthcare (Dallas, TX)
- …in health care field including, but not limited to, provider's office, managed care , or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS ... contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and… more
- Molina Healthcare (Dallas, TX)
- …with a minimum of 2 years' experience in health plan member interventions, managed care , or equivalent experience. + Demonstrated solid business writing ... opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation...1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting,… more