Register
Recruit Create CV

Health Plan Contracts Consultant Jobs in Richardson, Dallas, Texas

Information Technology - Health Plan, Remote - 50 Miles From Richardson, Texas
By TotalMed, Inc. At Richardson, TX, United States

Job Description We are seeking a Health Plan Information Technology for an assignment in Remote 50 miles from Richardson Texas. IT Specialists maintain and improve the technical systems of a ...

Senior Specialist, Health Strategy Plan Manager
By American Airlines At Dallas, TX, United States
Experience in health and well-being plans and program management
Additionally, the position is responsible for the strategic, financial and contractual management of health and well-being vendors plans and programs
Manages vendor relationships, contracts, and works collaboratively to ensure plan provisions and contractual requirements are implemented, interpreted, and administered correctly
Oversees vendor compliance and ensures all government regulatory requirements are managed within the plan policies and procedures
Ability to influence all levels of management and vendors
This job is a member of the Benefits Strategy and Planning Team within the People/HR Division
Fo Org Health Consultant
By Southwest Airlines At , Dallas, 75235, Tx $88,550 - $98,400 a year
Explore more Benefits you’ll love: https://careers.southwestair.com/benefits
Fly for free, as a privilege, on any open seat on all Southwest flights (your eligible dependents too)
Up to a 9.3% 401(k) Company match, dollar for dollar, of your eligible pay, per paycheck**
Potential for annual ProfitSharing contribution toward retirement - when Southwest profits, you profit***
Pay amount doesn’t guarantee employment for any particular period of time
Credentialing Specialist - The Health Plan
By Texas Children's Hospital At Greater Houston, United States
A minimum of three (3) years of managed care or health care experience
Group process and problem solving is helpful
Reviews and understands the internal policies & procedures for performing credentialing and
Re-credentialing primary source verification and file and report preparations for committee
Establishes individual files for each applicant containing the application, documents to support primary source verification and any other communications
Contacts providers to request updates to licenses and documents with expiration dates
Case Management Assistant - The Health Plan
By Texas Children's Hospital At , Houston, 77001, Tx
Two years of experience in Case management, community outreach, healthcare, and/or health insurance experience OR
Provides Support for Case Management Services.
Documents in current case management system.
Completes all eligibility and benefit data available on members before routing to Case Manager or Transition Specialist.
Three years of general administrative experience required
Two years of call/contact center experience preferred
Contracts Specialist - The Health Plan **Full Remote**
By Texas Children's Hospital At , Houston, 77001, Tx
Provides ongoing support to network management department and other internal customers as needed
Answers network management's main provider phone line and triage/resolve provider issues
Submits required reports, ad hoc reports, and completed projects to management in a timely manner
Two years' health care or managed healthcare experience required
Manages LOI process, prepares service forms for provider information and contract changes, works service flow queues for contract/application process
Bachelor degree may be substituted for the required experience
Senior Contracts Administrator - The Health Plan **Fully Remote**
By Texas Children's Hospital At , Houston, 77001, Tx
Makes recommendations to management regarding contracting strategy when contract proposals are not within Network Development established parameters/guidelines
Communicates provider trends to management and other parties as appropriate in a timely manner
Demonstrates proficiency with product requirements relating to provider contracting
In lieu of a Bachelor's degree, an additional four (4) years of related work experience is required
**Position is fully remote capable for in-state and out of state applicants. Certain exclusions may apply**
Negotiates hospital contract language and rates using established parameters/guidelines
Case Management Assistant - The Health Plan
By Texas Children's Hospital At Houston, TX, United States
Two years of experience in Case management, community outreach, healthcare, and/or health insurance experience OR
Provides Support for Case Management Services.
Documents in current case management system.
Completes all eligibility and benefit data available on members before routing to Case Manager or Transition Specialist.
Three years of general administrative experience required
Two years of call/contact center experience preferred
Customer Service - Health Plan, Austin, Texas
By TotalMed, Inc. At Austin, TX, United States

Job Description We are seeking a Health Plan Customer Service for an assignment in Austin Texas. Customer Service Representative handles customer calls by answering questions, finding ...

New Products Contracts Consultant
By Toyota North America At Plano, TX, United States
Direct the management of the vendor selection process (Requests for Information and Requests for Proposals) in partnership with Procurement.
Automotive knowledge and multimedia/telematics (in-vehicle and server) and automotive hardware (DCM, Head Unit) experience.
Experience with Toyota-specific contract terms and requirements.
Manage regulation check process for new initiatives.
Manage and own negotiating with complex contracts.
Collaborate with Legal, Procurement, Finance, and other Toyota groups to improve processes and ensure the best support for Connected Technology.
Quality Specialist - The Health Plan
By Texas Children's Hospital At , Houston, 77001, Tx
Works on projects, including preparation for health plan wide audits, as delegated by the Quality Management leadership, meeting assigned time frames
3 years' experience in performance improvement or quality required
Experience in a clinical environment preferred
Produces reports for quality improvement, guidelines, utilization, and outcomes, error-free and on time
Works with information systems and departmental representatives to evaluate, strategize and ensure data elements are available for collection and reporting
Coordinates agenda, meeting minutes and meeting requests for committee meetings, error free
Health Plan Operations Associate
By Firefly Health At Watertown, MA, United States
Have successfully proven remote-work time management skills
Assist members with questions regarding the Firefly Health Plan; Provider network, medications, prior authorizations, and Care-Pass requirements
Furnish benefits, claim status, eligibility checks, etc. to Providers on an Inbound and Outbound call basis.
Execute courteous, accurate, and prompt follow-up with customers by utilizing worklists to successfully manage daily tasks
Have excellent communication skills and love delivering great service to people, often at stressful moments in their health journey
Have experience using digital technology to improve service delivery
Health Plan Communications Specialist - Remote - Va Only
By Molina Healthcare At United States
1+ years’ experience assisting with the management of communications projects
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Edits, proofs, and reviews all communications to meet the Molina tone, voice, and style requirements
Ensures all state/federal regulatory and accreditation requirements are met in materials
Ensures regulatory approval of materials as required by state and federal requirements
2+ years marketing or communications experience
Coordinator - Health Plan, Remote- Fl, Florida
By TotalMed, Inc. At Florida, United States

Job Description We are seeking a Health Plan Coordinator for an assignment in Remote FL Florida. Administrative Coordinators perform clerical tasks including typing documents, compiling and ...

Coordinator - Health Plan, Remote- Tx, Texas
By TotalMed, Inc. At Texas, United States

Job Description We are seeking a Health Plan Coordinator for an assignment in Remote TX Texas. Administrative Coordinators perform clerical tasks including typing documents, compiling and filing ...

Customer Service Representative - Health Plan
By Morgan Stephens At Long Beach, CA, United States

Minimum Of 1-2 Years Customer Service Experience

Morgan Stephens ofrecemos reclutadores que hablan Espanol

Health Plan Liaison (Hybrid)
By Better Health Group At Tampa, FL, United States
Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
Demonstrate ability to manage time and organize meetings effectively
Demonstrate knowledge of Health Plan specific policies, procedures, and resources
All action items are completed by the due dates set forth by the Health Plan and Manager of Core Operations
At least 3 years of experience in a healthcare-related environment
Demonstrated resourcefulness, initiative, and results-oriented capabilities
Health Plan Liaison Manager (Hybrid)
By Better Health Group At Tampa, FL, United States
Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
Maintain tasks in the project management system to reflect any updates or changes to Core Operations processes
Review tasks for accuracy that require manual data entry
Demonstrated resourcefulness, initiative, and results-oriented capabilities
Excellent written and verbal communication skills.
Are you looking for a career opportunity that will help you grow personally and professionally?
Contracts Specialist/Manager Consultant
By TB Alliance At , New York, 10005 $85 - $105 an hour

Department: Admin/Operations Contracts Specialist/Manager Consultant Summary: TB ...

Customer Service Representative - Health Plan
By Morgan Stephens At Cincinnati, OH, United States

Knowledge, Skills, And Abilities Required

Morgan Stephens ofrecemos reclutadores que hablan Espanol

Vp, Health Plan Sales
By RxSense At , Boston
Report sales activity to management as required.
Perform or assist with any operations, as required to maintain workflow and to meet schedules and quality requirements.
Bachelor's degree or multiple years of Technology or PBM equivalent/relevant experience is required.
Interaction with key influencers as needed which may include Brokers/Consultants as directed.
Participate in and perform analysis of opportunities, potential client needs and objectives that fit corporate goals and objectives.
Delivery of Corporate Business Model and Value Proposition to prospects via phone call, email, conferences, speaking engagements, demos, and presentations.
Manager, Health Plan Delivery Services
By Availity, LLC. At ,
Managing, assigning, and prioritizing Health Plan implementation related project and program management activities through the implementation lifecycle
Identifying the roles, skills, and knowledge required and ensure staff has the resources and skills needed to support all work initiatives
Interested in furthering your education? We offer education reimbursement!
Bachelor’s degree or the equivalent in work experience
Minimum of 5 years of healthcare and/or IT related project implementations experience
Experience in interviewing and hiring practices
Health Plan Data Analyst Iii
By CareSource At , Remote $66,700 - $106,700 a year
Project management experience is preferred
Assimilate large quantities and/or complicated data into meaningful formats for tracking and status requirements.
Serve as Project Manager for select HPLC initiatives.
Perform any other job duties as requested
Bachelor’s degree or equivalent years of relevant work experience is required.
Minimum of three (3) years of data analysis or experience in a health care setting is required.
Hr Administrator (Wellsense Health Plan)
By Boston Medical Center At , Remote
Demonstrates sound time management and is well-organized.
Conducts HRIS systems trainings for new hires and new managers.
At least 3 years of HR administrative support experience required. Experience in a fast-paced, rapidly growing organization preferred.
Experience in the healthcare/health insurance industry preferred, not required.
Some knowledge of Federal and multi-State employment laws.
Conducts all job responsibilities with the highest degree of confidentiality.
Health Plan Specialist (Remote, 9/5 Start Date)
By Medica At United States
10:00am CST- 6:30pm CST (shift differential incentives are offered for this later shift)
10:30am CST- 7:00pm CST (shift differential incentives are offered for this later shift)
11:30am CST - 8:00pm CST (shift differential incentives are offered for this later shift)
12:00pm CST - 9:00pm CST (shift differential incentives are offered for this later shift)
Minimum requirement is HS diploma, or equivalent
2 years of related Customer Service experience
Health & Welfare Plan Delivery Lead
By GE HealthCare At Schenectady, NY, United States

Job Description Summary In this role, you will be responsible for the overseeing the delivery of Health and Welfare benefits to GE HealthCare participants, ensuring they are properly ...

Vp, Health Plan Systems
By Health Partners Plans At Philadelphia, PA, United States
Benefits & Wellness Program including generous Time Off
Develop and manage technology budgets for the health plan, ensuring that resources are allocated effectively to meet the organization's needs.
Excellent leadership, interpersonal, and communication skills.
Ability to effectively manage budgets and resources to meet the needs of the organization
Strong problem-solving skills and the ability to think creatively to solve complex technical problems.
Competitive Compensation Packages, including 401(k) Savings Plan with Company Match and Profit Sharing
Senior Manager, Health Plan Partnerships
By Maven Clinic At New York, NY, United States
Experience working with health plans, benefits consultants, benefits administrator and/or pharmacy benefit managers a plus
7+ years of experience, with a strong background in healthcare and/or benefits
Drive productive client meetings while proactively anticipating client needs and milestones specific to the employer benefits and health plan industry
Demonstrated ability to manage complex cross-functional projects
Experience building and improving processes for high growth company
Excellent oral and written communications skills; expert listening skills
Health Plan Analyst - Student Position
By Healthee At New York, NY, United States
Developing various reports, presentations and summarizing key findings from data analysis and communicating them to the management team.
Strong analytical skills and proficiency in data analysis tools
Excellent written and verbal communication skills, with the ability to present complex information in a clear and concise manner.
Detail-oriented with the ability to manage multiple tasks and prioritize effectively.
The job is 100% remote (it may be required to arrive to the Tel Aviv office as needed).
Compiling, organizing and analyzing health plan data to assist in delivering essential health plan information to users
Plan Document Consultant Jobs
By Voya Financial At United States
Successfully manage and execute plan document restatements from start to finish.
Offer plan design consultations with plan sponsors during the onboarding process.
Offer plan design consultations with plan sponsors during the amendment process.
Assist in the development workflows, tools and procedures to enhance the client experience around Voya’s plan document services.
5+ years’ experience with retirement plans and related rules/regulations.
Strong verbal, written and interpersonal skills.

Are you looking for an exciting opportunity to help shape the future of health plans? We are looking for a Health Plan Contracts Consultant to join our team and help us develop innovative and cost-effective health plans for our clients. As a Health Plan Contracts Consultant, you will be responsible for negotiating and drafting health plan contracts, analyzing and interpreting health plan documents, and providing guidance and advice to clients. If you have a passion for health care and a desire to make a difference, this is the job for you!

Overview:

A Health Plan Contracts Consultant is responsible for negotiating and managing contracts with health plans and other payers. They are responsible for ensuring that the contracts are compliant with applicable laws and regulations, as well as meeting the needs of the organization. The consultant must have a strong understanding of the health care industry and the ability to effectively negotiate and manage contracts.

Detailed Job Description:

The Health Plan Contracts Consultant is responsible for negotiating and managing contracts with health plans and other payers. This includes researching and analyzing the terms of the contracts, negotiating with payers, and ensuring that the contracts are compliant with applicable laws and regulations. The consultant must have a strong understanding of the health care industry and the ability to effectively negotiate and manage contracts. The consultant must also be able to develop and maintain relationships with payers and other stakeholders.

What is Health Plan Contracts Consultant Skills Required?

• Strong understanding of the health care industry
• Excellent negotiation and communication skills
• Ability to analyze and interpret contracts
• Knowledge of applicable laws and regulations
• Ability to develop and maintain relationships with payers and other stakeholders
• Excellent organizational and time management skills

What is Health Plan Contracts Consultant Qualifications?

• Bachelor’s degree in business, health care administration, or related field
• 5+ years of experience in health care contract negotiation and management
• Knowledge of applicable laws and regulations
• Ability to develop and maintain relationships with payers and other stakeholders

What is Health Plan Contracts Consultant Knowledge?

• Knowledge of the health care industry
• Knowledge of applicable laws and regulations
• Knowledge of contract negotiation and management
• Knowledge of health care reimbursement and payment models

What is Health Plan Contracts Consultant Experience?

• 5+ years of experience in health care contract negotiation and management
• Experience in developing and maintaining relationships with payers and other stakeholders
• Experience in analyzing and interpreting contracts

What is Health Plan Contracts Consultant Responsibilities?

• Negotiate and manage contracts with health plans and other payers
• Ensure that contracts are compliant with applicable laws and regulations
• Research and analyze the terms of the contracts
• Develop and maintain relationships with payers and other stakeholders
• Monitor and report on contract performance