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The AVP of Managed Care will have oversight responsibility for all managed care contracting activities for Surgery Ventures Group. The AVP will collaborate and assist with PCA VPs across the enterprise (e.g. PCHospital and Government AVP and RVP colleagues) on contracting activities with managed care organizations (“MCOs”) and other payers.
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Solid clinician skills and population health acumen including understanding of risk management, managed care contracting, national benchmarking, and related quality metrics. Baylor Scott & White Health Medical Director - BSWQA Dallas , Texas Apply Now Dir Medical Director - BSWQA is responsible for planning, overseeing, and directing strategic medical affairs for Baylor Scott and White Health (BSWH), which may include patient care operations, patient quality, patient safety, infection control, risk management, joint ventures, physician networks, and medical credentialing functions.
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As the OR RN Circulator , you will have responsibility for patient safety by designing, coordinating and delivering care to meet the needs of the surgical patient. Managed by United Surgical Partners International & Joint Commission Accredited.
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The mission of Correctional Managed Care is to address the healthcare needs of underserved patient populations within the Texas Department of Criminal Justice (TDCJ) and the Texas Juvenile Justice Department (TJJD.
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At least 5 years in health care, experience in an Accountable Care Organization, consulting, financial, network development, sales or managed care preferred. Signify's intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs.
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The Billing Representative is responsible for ensuring accurate billing, timely submission of electronic and / or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers.
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Dir Medical Director - BSWQA is responsible for planning, overseeing, and directing strategic medical affairs for Baylor Scott and White Health (BSWH), which may include patient care operations, patient quality, patient safety, infection control, risk management, joint ventures, physician networks, and medical credentialing functions.
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The channel includes any of the following customer types: reHealth Plans, Managed Care Organizations, Employer Groups, managed Medicaid and Medicare plans within the market access channel.
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RN Case Manager openings with a major health insurance / managed care company based in the Dallas, TX area! Experience with a managed care organization (MCO) Experience with medical decision support tools (i.e., InterQual, NCCN) and government sponsored managed care programs.
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Dallas, Texas | As a Managed Care Contract Analyst in the Managed Care department at Children’s Health, you’ll contribute to making life better for children by running data analysis, financial interpretation of contract terms, contract modeling, financial analysis, data validation, developing reimbursement methodologies, maintaining contracts in EPIC and identification of revenue enhancing opportunities.
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Provides care under the direct supervision of the Population Health Director of Care Management or Nurse Manager utilizing physician approved patient protocols according to established standards and best practice guidelines.
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A law firm in Dallas is seeking a skilled Managed Care/Healthcare Reimbursement Litigation Lawyer with a focus on provider-side representation. Managed Care/Healthcare Reimbursement Litigation Lawyer.
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Qualifications (Minimum Requirements) Extensive knowledge of PBM, specialty pharmacy or managed care environments (5-7 years minimum experience). Lead and cultivate multi-level client relationships with senior executives, pharmacy department leadership and personnel, sales and product leads, clinical management and others which enable PSG to partner with clients to create, communicate and implement pharmacy strategy within the context of the overall healthcare strategy.
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The Monarch at Richardson, an AgeWell Solvere Living managed community, is currently hiring for our beautiful senior living community located in Richardson, TX. We offer both Assisted Living and Memory care services to our residents and are located in a multiplex area which allows for easy access to the community by public transportation such as bus and train transportation.
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Supports the clinical activities of PCHP Utilization Management, Quality Management, Clinical Policy, Technology Assessment, Credentialing, Population Health and Fraud, Waste and Abuse Functions to assure comprehensive, high quality health care to plan members in accordance with managed care and PCHP policies.
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managed care jobs in Dallas, TX
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