- The Cigna Group (Houston, TX)
- **Position Overview:** The individual is accountable to the Cigna Healthcare - Medicare Operations Issue Management Team. This role will serve supporting the ... Issue Management Team for all reporting needs and analyze data...data as it pertains to issues reporting by the business . We are looking for a self-starter that enjoys… more
- USAA (San Antonio, TX)
- …will involve execution of any Issue Management matters for Medicare Supplement claim issues. As business process owner, plans, directs, and coordinates ... makes us so special! **The Opportunity** We are currently seeking a dedicated ** Business Process Owner Senior** that will support Medicare Supplement Claims for… more
- Banner Health (TX)
- …8:00 AM - 5:00 PM (AZ Time). In this position you will be monitoring Medicare Advantage Parts C & D operational control measures ensuring appropriate oversight is in ... is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D. + Identifying and...timely and accurate fashion, including the resolution of each case/ issue identified and closed. + Participating in the preparation… more
- Molina Healthcare (Port Arthur, TX)
- …familiarity with various managed healthcare provider compensation methodologies, primarily across Medicare or Medicaid lines of business , including but not ... Provider Services activities for the state health plan. Works with direct management , corporate, and staff to develop and implement standardized provider servicing… more
- Texas Health Resources (Arlington, TX)
- …and Decision Support. o Matrix responsibilities and liaison for patient accounting, including business services and supply chain management . o The accounting of ... as the matrix administrator and has "dotted line" responsibility for the Business Services, Supply Chain Management , Accounting Services, and Privacy/Compliance… more
- Evolent Health (Austin, TX)
- …basis, reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with Physician Business Managers to ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...you will be a key member of the utilization management team. We can offer you a meaningful way… more
- Molina Healthcare (Dallas, TX)
- …Healthcare and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, ... with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business , including but not limited to,… more
- Humana (Austin, TX)
- …operational and support groups within IT and with outside groups including Business Continuity and Crisis Management . Influences program strategy, development of ... and continuously refine a robust DR testing framework, safeguarding our business operations. Your leadership will be crucial in orchestrating cross-functional teams,… more