Diversity, Equity

Job Summary We are looking for a Contract Specialist -- someone who works well in a fast-paced setting. In this position, you will be responsible for supporting network management by completing research projects, processing and implementing provider agreements and provider changes, and answering provider calls. This position is also responsible for managing...

Job Summary We are searching for a Senior Call Center Representative- someone who works well in a fast-paced setting. In this position, you will serve as a member and/or provider advocate that understands the organization's processes, policies, and procedures to investigate, resolve and/or facilitate the resolution of simple to complex issues/questions. You...

Job Summary We are looking for a Contract Specialist -- someone who works well in a fast-paced setting. In this position, you will be responsible for supporting network management by completing research projects, processing and implementing provider agreements and provider changes, and answering provider calls. This position is also responsible for managing...

Job Summary We are searching for a Senior Compliance Specialist -- someone who works well in a fast-paced setting. In this position, you will independently and cooperatively plan and manage audits, reviews, investigations, and projects to ensure compliance with the hospital's policies/procedures and state and federal rules, regulations, and statutes. This...

Case Manager (Registered Nurse) - Behavioral Health - The Health PlanJob Summary We are searching for a Case Manager for Behavioral Health -- someone who works well in a fast-paced setting. In this position, you will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs. This position provides...

Utilization Management Clinical Registered Nurse (RN)Job Summary We are searching for a Utilization Management Clinical RN -- someone who works well in a fast-paced setting. In this position, you will provide precertification of inpatient hospitalizations and all outpatient procedures and services requiring authorization. This role performs telephonic...

Job Summary We are searching for an Assistant Director of Network Development -- someone who oversees the development and maintenance of the contracted network of hospitals, physicians and other healthcare providers who provide care to Texas Children's Health Plan. This position assists in the development of policies and procedures for provider contracting...

Job Summary We are searching for a Director of Provider Relations - someone who works well in a fast-paced setting. In this position, you will be responsible for maintaining a best-in-class provider network management organization that spans multiple service delivery areas and products. This includes all functions and systems supporting provider relations,...

Job Summary We are searching for a Business Analyst - someone who works well in a fast-paced setting. In this position, you will perform process, procedure, and forms analysis and design within the department in order to enable a better integration of functional and technical processes and to provide quality improvements and measurements within business...

Job Summary We are searching for a Bilingual Marketing Event Planner -- someone who works well in a fast-paced setting. In this position, you will oversee and facilitate all aspects, where applicable, of TCHP corporate and member marketing programs planning from site selection, vendor negotiation, event registration, marketing, communications, onsite...

Case Manager (Registered Nurse) - South/SE Houston/- The Health PlanJob Summary We are searching for a Case Manager (Registered Nurse) -- someone who works well in a fast-paced setting. In this position, you will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs. This position provides...

Utilization Management Clinical Registered Nurse (RN) - The Health PlanJob Summary We are searching for a Utilization Management Clinical RN -- someone who works well in a fast-paced setting. In this position, you will provide precertification of inpatient hospitalizations and all outpatient procedures and services requiring authorization. This role...

Job Summary We are searching for a Utilization Management Clinical LVN - someone who works well in a fast-paced setting. In this position, you will provide precertification of inpatient hospitalizations and outpatient procedures and services requiring authorization. This process includes clinical judgment, utilization management application, verification of...

Job Summary We are searching for a Utilization Management Clinical LVN -- someone who works well in a fast-paced setting. In this position, you will provide precertification of inpatient hospitalizations and outpatient procedures and services requiring authorization. This process includes clinical judgment, utilization management application, verification...

Job Summary We are searching for a Configuration Analyst -- someone who works well in a fast-paced setting. In this position, you will be responsible for the activities related to system updates, new health plan implementations, and conversions within Business Operations. Designs configurations solutions to meet new business requirements and perform updates...

Job Summary We are searching for a Case Manager (Registered Nurse) - someone who works well in a fast-paced setting. In this position, you will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs. This position provides comprehensive ongoing case management services by coordinating and...

Job Summary We are searching for a Configuration Analyst -- someone who works well in a fast-paced setting. In this position, you will be responsible for the activities related to system updates, new health plan implementations, and conversions within Business Operations. Designs configurations solutions to meet new business requirements and perform updates...

Job Summary We are searching for a Utilization Management Clinical LVN - someone who works well in a fast-paced setting. In this position, you will provide precertification of inpatient hospitalizations and outpatient procedures and services requiring authorization. This process includes clinical judgment, utilization management application, verification of...

Job Summary We are searching for a Business Process Specialist - someone who works well in a fast-paced setting. In this position, you will support and develop programs aligned with Health Plan strategic goals through effective and timely assessment and equitable distribution of resources and assignments, education and implementation of processes and...

Job Summary We are searching for an Authorization Specialist - someone who works well in a fast-paced setting. In this position, you'll be responsible for supporting the pre-admission and admission process, ensuring financial authorization for service is obtained and to providing the authorizing entity with clinical information, including diagnosis and...