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Health care manager • dallas tx

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Program Manager Health Economics Value-Based Care- Health Plan

Program Manager Health Economics Value-Based Care- Health Plan

Parkland HealthDallas, TX, US
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Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Health Care Consulting Director- Revenue Cycle

Health Care Consulting Director- Revenue Cycle

Moss Adams LLPDallas, TX, United States
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Health Care Consulting Director- Revenue Cycle.At Moss Adams, we champion authenticity.For us, that means fostering a culture of talented people who care-about you, about our clients, and about our...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Tax Principal - Health Care and Life Sciences

Tax Principal - Health Care and Life Sciences

CliftonLarsonAllenDallas, TX, US
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CLA is a top 10 national professional services firm where our purpose is to create opportunities every day, for our clients, our people, and our communities through industry-focused wealth advisory...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Health Actuary- Manager

Health Actuary- Manager

PricewaterhouseCoopers Advisory Services LLCDallas,TX
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SummaryA career in our Benefits practice, within People and Organisation Consulting services, will provide you with the opportunity to help our clients reset their talent strategies and deliver ext...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Health Care SME Tester

Health Care SME Tester

Tata Consultancy ServicesIrving, TX
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Technical / Functional Skills : .Clinicaland Benefit Testing SME.Has the ability tounderstand technical specifications and create test cases based on Clinical andbenefit plan understanding.Has unders...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Health Care Litigation Associate Attorney

Health Care Litigation Associate Attorney

Crowell & MoringDallas, TX, US
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Crowell & Moring LLP is an international law firm with offices in the United States, Europe, MENA, and Asia that represents clients in litigation and arbitration, regulatory and policy, intelle...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Behavioral Health Care Planner

Behavioral Health Care Planner

VirtualVocationsIrving, Texas, United States
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A company is looking for a Care Planner Behavioral Health.Key Responsibilities Provide support to behavioral health clinical teams to enhance member engagement and care delivery Educate members ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
LTSS Service Care Manager - Behavioral Health

LTSS Service Care Manager - Behavioral Health

Centene CorporationIrving, 222 W Las Colinas Blvd, US
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You could be the one who changes everything for our 28 million members.Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll ha...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Health & Safety Manager

Health & Safety Manager

JPIDallas, TX, United States
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Built on a foundation of integrity, respect, and commitment, JPI stands out as one of the most active real estate developers and builders in the nation. For more than 35 years, JPI has designed and ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Project Manager - Health

Project Manager - Health

HKSDallas, US
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HKS Dallas is seeking a talented Project Manager to join our health team.A primary managerial position in a specific project and shares responsibility for project successes.Recognized ability to im...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Registered Nurse Care Manager-Health Plan Admin

Registered Nurse Care Manager-Health Plan Admin

Christus HealthCockrell Hill, TX, US
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The RN Care Manager (CM) II works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. The CM ensures that the pat...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
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Program Manager Health Economics Value-Based Care- Health Plan

Program Manager Health Economics Value-Based Care- Health Plan

Parkland Health & Hospital SystemDallas, TX, US
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Program Manager Health Economics Value-Based Care- Health Plan.Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Health Care Consulting Director- Revenue Cycle

Health Care Consulting Director- Revenue Cycle

Dallas StaffingDallas, TX, US
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Health Care Consulting Director- Revenue Cycle.At Moss Adams, we champion authenticity.For us, that means fostering a culture of talented people who careabout you, about our clients, and about our ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
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Clinical Social Worker Health Care Facility Surveyor

Clinical Social Worker Health Care Facility Surveyor

Greenlife Healthcare StaffingIrving, TX, US
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Clinical Social Worker Health Care Facility Surveyor - Texas (#1280).Employee retirement plan (401k).CMS’s Long-Term Care Basic Training and SMQT certification are required.Impact Recruiting ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Ambulatory Care Manager

Ambulatory Care Manager

Aya HealthcareDallas, TX, US
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With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we st...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Program Manager Health Economics Value-Based Care- Health Plan

Program Manager Health Economics Value-Based Care- Health Plan

Parkland Health and Hospital SystemDallas, TX, US
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Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Health Care Marketer

Health Care Marketer

Texas Allergy and Breathing CentersDallas, TX, US
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We are seeking a dynamic and experienced Health Care Marketer to join our team.The ideal candidate will be responsible for promoting our pulmonary, allergy, and sleep services across medical office...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Care Manager

Care Manager

Sunrise Senior LivingDallas, TX, US
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When you join Sunrise Senior Living, you will be able to use your unique skills to empower residents to live longer, healthier, and happier lives. Not only will you build meaningful relationships wi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
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Rural Program Consultant, Health Care Quality

Rural Program Consultant, Health Care Quality

Texas StaffingDallas, TX, US
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Rural Program Consultant, Health Care Quality.Since our founding in 1924, we've cut cardiovascular disease deaths in half, but there is still so much more to do. To overcome today's biggest health c...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
Program Manager Health Economics Value-Based Care- Health Plan

Program Manager Health Economics Value-Based Care- Health Plan

Parkland HealthDallas, TX, US
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Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission : the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.

Primary Purpose

Parkland Community Health Plan’s (PCHP’s) Health Economics Program Manager monitors cost trends, identifies performance improvement opportunities and develops strategies to support value-based care contracting initiatives across PCHP’s health plan networks. Develops contract pricing models, contract performance models, key performance indicators / metrics and other ad hoc analyses to support continuous network development and performance improvement.

Minimum Specifications

Education

  • Bachelor's degree in Business Administration, Healthcare Administration, Healthcare Analytics, Finance, Statistics or a related field.
  • Master’s degree in a related field is preferred.

Experience

  • Four (4) years of experience in a health plan or Medicaid Managed Care Organization.
  • Two (2) years of experience in medical / health economics, and network decision support.
  • Experience with value based / accountable care data analytics is preferred.

    • Equivalent Education and / or Experience

  • May have an equivalent combination of education and experience to substitute for both the education and the experience requirements

    • Certification / Registration / Licensure

  • Six Sigma or Project Management certification is preferred.

    • Skills or Special Abilities

  • Knowledge of managed care contracts and principles and concepts of statistical analysis.
  • Must have demonstrated skill in complex modeling, pro forma, projections and metric reporting.
  • Must have demonstrated ability to support and develop performance improvement strategies.
  • Excellent verbal and written communication skills including the ability to influence, negotiate and interact effectively with a range of business stakeholders
  • Strong interpersonal and conflict resolution skills with the ability to establish and maintain effective working relationships across and beyond the organization.
  • Excellent analytical and problem-solving skills.
  • Strong time management and organizational skills with the ability to manage multiple demands and respond to rapidly changing priorities.
  • Ability to write clearly and succinctly with a high level of attention to detail.
  • Proficient computer and Microsoft Office skills.
  • Ability to learn new software programs.
  • Knowledge of Texas Medicaid, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual is preferred.

    • Responsibilities

    Operational Support

  • Develops standardized and ad-hoc models to support contract pricing and contract and network performance.
  • Develops actionable data driven recommendations and supports the strategic decision-making process.
  • Prepares, supports, and presents materials for the contract negotiation process.
  • Supports and facilitates health plan budgeting, forecasting and cost-containment initiatives.
  • Supports and facilitates new product and new network development initiatives.

    • Reporting and Analysis

  • Develops and maintains the library of management information reports to support Network Development and Provider Relations.
  • Monitors cost trends.

    • Quality and Performance Improvement

  • Identifies performance improvement opportunities and facilitates initiates, both internally and externally.
  • Creates and implements performance improvement initiatives for PCHP.
  • Develops and maintains key performance indicators and performance measurement reports.
  • Integrate health literacy principles into all communication including Members and Providers.
  • Support strategies that meet clinical, quality and network improvement goals.
  • Promote the use of Health Information Technology to support and monitor the effectiveness of health and social interventions and make data-driven recommendations as needed.
  • For staff in clinical roles, foster collaborative relationships with members and / or providers to promote and support evidence-based practices and care coordination.

    • Regulatory

  • Ensures work is carried out in compliance with regulatory and / or accreditation standards as well as contractual requirements.

    • Professional Accountability

  • Promotes and supports a culturally welcoming and inclusive work environment.
  • Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values.
  • Adheres to organizational policies, procedures, and guidelines.
  • Completes assigned training, self-appraisal, and annual health requirements timely.
  • Adheres to hybrid work schedule requirements.
  • Attends required meetings and town halls.
  • Recognizes and communicates ethical and legal concerns through the established channels of communication.
  • Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information.
  • Maintains confidentiality at all times.
  • Performs other work as requested that is reasonably related to the employee’s position, qualifications, and competencies.

    • Job Accountabilities

  • Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of PCHP.
  • Stays abreast of the latest developments, advancements, and trends in the field by attending seminars / workshops, reading professional journals, actively participating in professional organizations, and / or maintaining certification or licensure. Integrates knowledge gained into current work practices.
  • Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding.

    • Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status. As part of our commitment to our patients and employees’ wellness, Parkland Health is a tobacco and smoke-free campus.