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Health Plan Manager Jobs in 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
Manager Behavioral Health - Health Plan
By Baylor Scott & White Health At , Temple, 76502 $36.26 an hour
Demonstrated ability to evaluate and stabilize team and separate workloads through effective time management, prioritization, and organizational skills.
Demonstrated leadership, communication, organizational and problem-solving skills.
Immediate eligibility for health and welfare benefits
EXPERIENCE - 2 Years of Experience
Our competitive benefits package includes the following
Note: Benefits may vary based on position type and/or level
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
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 ...

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
Business Analyst - The Health Plan **Fully Remote**
By Texas Children's Hospital At , Houston, 77001, Tx
Obtains and maintains knowledge of regulatory information with TCH team members
3 years experience with business operations, systems development or business related analytic and communications experience.
Participates in work groups/ focus groups
Performs analyses of various reports to compose summaries, business plans, PowerPoint presentations and/or recommendations to leadership and stakeholders
Performs integrated analysis of chargemasters and various financial reports and determine departmental needs.
Develops summaries of financial analysis and makes recommendations to leadership team.
Service Coordinator Advanced Social Worker (Tyler/Longview/Jacksonville) - The Health Plan
By Texas Children's Hospital At Houston, TX, United States
Assures timely performance of utilization management processes to maintain compliance with Federal, State, and Managed Care contract regulations
CCM from Adult and Pediatric Integrated Case Management preferred
3 years’ experience in pediatrics particularly with patients with disabilities aged 0-20 preferred
Maintains current education and training to adeptly identify the Member's physical, behavioral, functional, and psychosocial needs
Knowledge of Microsoft Word, Excel and Outlook preferred
Plans and executes interdisciplinary and patient/family conferences as necessary to formulate and communicate the plan of care
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
100% Remote - Project Manager (Health Plan Pmo)
By Beacon Hill Staffing Group At Norfolk, VA, United States
A minimum 5 years of experience in a Project Management role
Must have a five-year track record of success in project and or program management. Should need limited training.
Enthusiastic project managers, been doing PM for at least 4-5 yrs.
Certifications - PMI/PMP. Not required but gold standards.
A minimum 3 years of experience in the Health Insurance Industry (Payer)
NOTE: This is a 100% remote position. Candidates need to be from the following states.
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?
Health Plan Nurse Coordinator I - Behavioral Health
By CenCal Health At , Santa Barbara, 93110 $69,681 - $104,522 a year
Demonstrate strong multi-tasking, organizational, and time-management skills.
1-2 years of experience in crisis or risk assessment or case management
Adhere to Health Plan, Medical Management and Health Services policies and procedures.
Function as a collaborative member of Medical Management/Health Services’ multi-disciplinary medical management team
Identify and report quality of care concerns to management and as directed, to appropriate CenCal Health department for follow up.
Understand basic case and disease management concepts, principles and practices as described in the Case Management Society of America
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
Client Success Associate - Health Plan
By Included Health At United States
Advanced computer and analytic skills, including experience creating client presentations that tell a compelling story of value delivered
3-5 years of experience of demonstrated success in account-based marketing, sales, Client Success or health care administration and benefits
Manage inbox for client inquiries, coordinating across internal departments to find answers and deliver superior client service
Develop and deliver regular reports for clients, and provide client education as needed
Excellent interpersonal, presentation, and persuasion skills with the ability to diplomatically navigate the complexity of client relationships
Superior customer service skills with the ability to articulate and respond to highly complex issues
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.
Vp Or Dir Of Health Plan Operations
By myPlace Health At Los Angeles, CA, United States
Manage enrollment data and data systems including data transfers and the development and management of systems to meet PACE programmatic requirements
Manage and provide oversight to our TPA, PBM, pharmacy services, and other key vendors, including claims management, issue resolution, and receivables/payables
Experience in corporate finance, venture-backed startups, private equity, investment banking, or other finance-focused roles in high-growth and entrepreneurial environments
Prior experience building from the ground up or scaling a Finance & Accounting function at a high-growth healthcare organization preferred
Los Angeles preferred; relocation benefits offered if willing to reside in the Los Angeles metro area
Develop policies and procedures that meet applicable PACE program requirements
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.
Sales Executive (Health Plan Sales) - Remote Opportunity
By Tivity Health, Inc. At , Remote
Develop a solid understanding of the organizational strategies, solutions and services to help benefit targeted health plans by implementing our solutions.
Bachelor's degree in Business or Marketing preferred, or relevant experience.
Demonstrated experience exceeding sales activity, revenue, and profit goals
Relevant experience in “solution” vs. “product” sales, including ROI selling techniques
Engage as a key team member in the health plan account development strategy.
Ensure CRM database contains current information on revenue potential, close probability, etc. for all prospects.
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