Business Process Specialist
4 weeks ago
Job Summary:
We are seeking a highly skilled Business Process Specialist to join our team at Texas Children's Health Plan. The successful candidate will be responsible for supporting and developing programs aligned with strategic health plan goals, conducting effective and timely assessments, and implementing processes and procedures that maintain a cost-effective provider network.
Key Responsibilities:
* Support and develop programs aligned with strategic health plan goals
* Conduct effective and timely assessments and equitable distribution of resources and assignments
* Educate and implement processes and procedures that maintain a cost-effective provider network
* Participate in Medical Policy, Reimbursement Committee, and other workgroups
* Facilitate process and/or system changes and propose, implement, and support quality control measures
* Perform reviews of current and newly implemented processes to ensure accurate reporting and deliverables
* Lead collaborations with other departments to meet compliance standards
* Manage process and workflow for audit response, contract adherence, and regulatory compliance
* Prioritize key project tasks and deliverables, and identify project risks, issues, and dependencies
* Demonstrate effective issue resolution skills
* Exhibit excellent written and verbal communication skills and the ability to manage several complex situations simultaneously
* Possess leadership, creativity, integrity, initiative, and sound problem-solving skills
* Pay attention to detail and follow-up
Requirements:
* 2 years of experience in a managed care organization (MCO) or related healthcare organization
* A Master's degree in Business, Health Care Administration, Public Health, Nursing, MIS, or an IS-related field may substitute for 2 years of required experience
* License: Not specified
* Certifications: Not specified
* Must-Have: Experience with Claims, Experience with Regulatory, Experience with Texas Medicaid, Experience in Tapestry (preferred), Bachelor's Degree in Business, Health Care Administration, Public Health, Nursing, MIS, or an IS-related field
-
Business Process Specialist
4 weeks ago
Bellaire, Texas, United States Deans Professional Services Full timeJob DescriptionWe are seeking a highly skilled Business Process Specialist to join our team at Dean's Professional Services. As a Business Process Specialist, you will play a critical role in supporting and developing programs aligned with health plan strategic goals.Key Responsibilities:Support the facilitation of process and/or system changes through...
-
Certified Sterile Processing Specialist
4 weeks ago
Bellaire, Texas, United States Memorial Hermann Health System Full timeJob SummaryAs a Sterile Processing Technician III at Memorial Hermann Health System, you will play a critical role in ensuring the highest level of patient care by providing sterilized surgical instruments, supplies, and equipment to the operating room and other areas of the hospital.This position requires a high level of attention to detail, organizational...
-
Certified Sterile Processing Specialist
3 weeks ago
Bellaire, Texas, United States Memorial Hermann Health System Full timeAt Memorial Hermann Health System, we strive to deliver exceptional care and create a positive work environment for our employees. When our employees feel valued and supported, they are empowered to provide outstanding care to our patients.Job SummaryThis position is responsible for providing sterilized surgical instruments, supplies, and equipment to the...
-
Senior Business Development Liaison
4 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob SummaryWe are seeking a highly skilled Senior Business Development Liaison to join our team at Texas Children's Hospital. As a key member of our business development team, you will be responsible for developing and executing strategic plans to acquire, grow, and nurture strong relationships with physicians and their staff. Your goal will be to drive...
-
Insurance Business Development Representative
4 weeks ago
Bellaire, Texas, United States Goosehead Insurance Agency Full timepbBuild a Successful Insurance Career with Goosehead Insurance Agency/b/ppWe are seeking a highly motivated and results-driven Insurance Business Development Representative to join our team. As an Account Growth Specialist, you will be responsible for building a book of business through prospecting and establishing referral partner relationships with...
-
Utilization Management Specialist
3 weeks ago
Bellaire, Texas, United States Texas Children's Hospital Full timeJob Title: Utilization Management SpecialistLocation: Houston, TXJob Type: ContractDuration: 3+ monthsPay: $20-$24 per hourJob Description:We are seeking a skilled Utilization Management Specialist to join our team at Texas Children's Hospital. As a Utilization Management Specialist, you will be responsible for processing initial incoming faxes or phone...
-
Healthcare Utilization Specialist
3 weeks ago
Bellaire, Texas, United States Integrated Resources Full timeJob Title: Healthcare Utilization SpecialistJob Summary:Integrated Resources is seeking a skilled Healthcare Utilization Specialist to join our team. As a key member of our medical management department, you will be responsible for processing initial incoming faxes or phone requests into the intake department. Your primary duties will include gathering...
-
Administration Specialist
4 weeks ago
Bellaire, Texas, United States PRIDE Health Full timeJob Summary:We are seeking an experienced Administration Specialist to join our team at PRIDE Health. As a key member of our Quality Management department, you will be responsible for ensuring the highest standards of quality in our administrative processes.Key Responsibilities:* Provide administrative support to the Quality Management team* Develop and...
-
Ambulatory Infusion Nurse Specialist
3 weeks ago
Bellaire, Texas, United States Elevance Health Full timeJob DescriptionAre you a skilled and compassionate Registered Nurse looking to take your career to the next level? We are seeking a talented Ambulatory Infusion Nurse Specialist to join our team at Paragon Healthcare in Bellaire, TX.Job Summary:The successful candidate will be responsible for administering ordered therapies, preparing medications, and...
-
Administrative Support Specialist
3 weeks ago
Bellaire, Texas, United States Houston Independent School District Full timeJob SummaryThe Office Manager 2 will ensure the smooth operation of the office by providing comprehensive administrative support. This role requires strong organizational skills, attention to detail, and the ability to multitask.Key ResponsibilitiesManage day-to-day office activities, coordinating resources and supporting various teams.Provide administrative...
-
Phlebotomy Specialist
1 month ago
Bellaire, Texas, United States Houston Methodist Full timeJob SummaryThe Phlebotomist II performs a variety of tasks to collect and process biological specimens for laboratory testing. This role requires strong interpersonal and team player skills, as well as the ability to maintain accuracy and efficiency in a fast-paced environment.Key ResponsibilitiesCollect and process biological specimens for laboratory...
-
Epic Application Specialist
3 weeks ago
Bellaire, Texas, United States Insight Global Full timeJob SummaryThe Application Analyst position is responsible for providing expert-level support and configuration of assigned applications. This role entails assisting, training, and supporting customers and other analysts with the operation and administration of systems.Key ResponsibilitiesAssist and train customers and other analysts on the operation and...
-
Administrative Support Specialist
3 weeks ago
Bellaire, Texas, United States Houston Independent School District Full timeJob SummaryThe Administrative Services Manager will ensure the smooth operation of the office and provide comprehensive administrative support to the Houston Independent School District. This role requires strong organizational skills, attention to detail, and the ability to manage multiple tasks and priorities.Key ResponsibilitiesManage day-to-day office...
-
Medical Management Assistant
4 weeks ago
Bellaire, Texas, United States Texas Children's Health Plan Full timeJob Title:Medical Management Assistant Job Specialty:Healthcare Operations Job Duration: 13 weeks Shift: Hybrid - Day shift (8:00 am to 5:00 pm or 8:30 am to 5:30 pm or 9:00 am to 6:00 pm)Guaranteed Hours: 40.00 per week Experience: Previous experience in managed care, especially in a medical management department, claims, or member service. Healthcare...
-
Plant Operations Specialist
4 weeks ago
Bellaire, Texas, United States Government Jobs Full timeJob Summary: We are seeking a skilled Plant Operator to join our team at Government Jobs. The successful candidate will be responsible for operating and maintaining industrial plant equipment, ensuring the smooth operation of our facilities.Key Responsibilities:* Operate and maintain industrial plant equipment, including pumps, valves, and other machinery*...
-
Regional Healthcare Specialist
3 weeks ago
Bellaire, Texas, United States Elevance Health Full timeJob Summary:We are seeking a skilled Regional Registered Nurse to join our team at Paragon Healthcare, a proud member of the Elevance Health family of companies. As a Regional Registered Nurse, you will be responsible for the administration of all ordered therapies in our ambulatory infusion centers.Key Responsibilities:Prepare and administer ordered...
-
Authorization Management Specialist
3 weeks ago
Bellaire, Texas, United States Harris Health System Full timeKey Responsibilities:Verify third-party information with carriers, employers, and review agencies to ensure accurate billing and reimbursement for services. Obtain authorizations, pre-certifications, and verify third-party coverage to guarantee seamless healthcare delivery. Collaborate with cross-functional teams to optimize benefits and reimbursement...
-
Medical Research Laboratory Specialist
3 weeks ago
Bellaire, Texas, United States Pinnacle Clinical Research Full timeJob SummaryWe are seeking a highly skilled and detail-oriented Laboratory Technician to join our team at Pinnacle Clinical Research. As a Laboratory Technician, you will play a critical role in the day-to-day operations of our lab, ensuring the highest quality of research and patient care.Key ResponsibilitiesLab Operations: Perform lab tests, collect subject...
-
Strategic Portfolio Management Director
3 weeks ago
Bellaire, Texas, United States Sysco Full timeJob Summary:The Director, Strategic Portfolio Management is responsible for leading the Technology portfolio management function. This role provides guidance to technology leadership and other executives on the timing and anticipated value of initiatives and investments, tracks progress, and helps identify potential conflicts and dependencies to streamline...
-
Forklift Operator
4 weeks ago
Bellaire, Texas, United States U.S. Silica Full timeJob SummaryU.S. Silica is seeking a skilled Forklift Operator to join our team in Katy, Texas. As a key member of our operations team, you will be responsible for safely operating and maintaining the Cradle/Stand sand delivery system, performing preventative maintenance, and communicating directly with the data van during stage operations.This role requires...