Top 337 Claims manager Jobs in Forney Tx

Payor Contract Manager, Infusion
Elevance Health —Plano, TX
- $111,132 - $166,698 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Employee stock purchase plan
- Paid holidays
3d
Storm Restoration Sales & Project Manager | Top first-year performers earn $150K+
Heritage Construction Co., LLC —Dallas, TX
- From $100,000 a year
- Full-time
- Customer service
- No experience needed
- Driver's License
- Paid training
Quick Apply
TX, RN Certified Case Manager - Workers Compensation
The Reny Company —Dallas, TX
- $80,000 - $90,000 a year
- 8 hour shift
- Remote
- Nursing
- RN License
- Research
- Mileage reimbursement
- Disability insurance
Quick Apply
Facility Administrator / Nurse Manager
TotalCare —Garland, TX
- Full-time
- CPR Certification
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
Manager, Retirement Plans
ATI —Dallas, TX
- 7 years
- System design
- Office
- 401(k)
Quick Apply
Civil Engineer Design-Build Leader – Vice President / Principal-in-Charge
Huitt-Zollars —Dallas, TX
- Full-time
- Office
- Bachelor's degree
- Travel
- Commuter assistance
- AD&D insurance
Quick Apply
Construction Project Manager: Travel
Mission Critical Interior Solutions, Inc —Dallas, TX
- From $95,000 a year
- Full-time
- Background check
- Construction site
- 5 years
- Health insurance
- Dental insurance
Quick Apply
Dental Office Manager/Treatment Coordinator
Affordable Dentist Near Me in Dallas —Dallas, TX
- $18 - $35 an hour
- Full-time
- Dental office
- Team management
- Patient care
- Health insurance
- Dental insurance
Quick Apply
Heavy Civil Project Manager
Thalle Construction Company —Texas
- Civil engineering
- Construction site
- Bachelor of Science
- Paid holidays
- Disability insurance
Quick Apply
Roofing Sales Manager in Training
Blue Angel Roofing and General Contractors, LLC —Dallas, TX
- $85,000 - $105,000 a year
- Full-time
- Customer service
- Military
- Mid-level
- Paid training
- Opportunities for advancement
Quick Apply
11h
Roofing Sales Manager in Training
Blue Angel Roofing and General Contractors, LLC —Plano, TX
- $85,000 - $105,000 a year
- Full-time
- Customer service
- Military
- Mid-level
- Paid training
- Opportunities for advancement
Quick Apply
11h
Onsite Manager
Eclipse Advantage —Garland, TX
- Overtime
- Spanish
- Customer service
- Pass drug screening
- Paid time off
- 401(k) matching
Quick Apply
Construction Sales Project Manager
Heritage Construction Co., LLC —Dallas, TX
- From $100,000 a year
- Full-time
- Hospitality
- Driver's License
- Outdoor work
- Paid training
- Health insurance
Quick Apply
3d
Field Claims Manager I
The Cincinnati Insurance Companies —Dallas, TX
- $115,000 - $130,000 a year
- Customer service
- 5 years
- Bachelor's degree
Manager, Claims
AmTrust Financial Services, Inc. —Dallas, TX
- Full-time
- Bachelor of Science
- Mid-level
- Office
- Relocation assistance
- Health insurance
Manager Professional Billing & Denial Recovery
Methodist Health System —Dallas, TX
- Full-time
- Hybrid work
- 3 years
- Master's degree
- Bachelor's degree
RN Manager Home Health Quality Assurance
UT Southwestern —Dallas, TX
- Full-time
- Nursing
- 5 years
- Bachelor's degree
- Paid parental leave
- Paid holidays
Manager, Benefit Operations Testing & QA
SmithRx —Plano, TX
- Overtime
- Remote
- Bachelor's degree
- Continuous improvement
- Mentoring
- Commuter assistance
- Paid parental leave
Quick Apply
Registered Nurse (Clinical Nurse Leader) - EDRP Authorized
US Veterans Health Administration —Dallas, TX
- $78,714 - $181,738 a year
- Weekends as needed
- Background check
- Nursing
- RN License
- Paid holidays
- Loan repayment program
Program Manager/Training Lead
Contact Government Services, LLC —Dallas, TX
- $180,000 - $200,000 a year
- Full-time
- 5 years
- Mid-level
- Supervising experience
- Health insurance
- Dental insurance
Quick Apply

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claims manager jobs near forney tx

Payor Contract Manager, Infusion

Elevance Health -
Plano, TX

Apply Now

Job Details

Full-time
$111,132 - $166,698 a year
3 days ago

Benefits

Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Financial forecasting
Contract documentation review
Operational analysis
Pharmacy Information Systems (PIS)
Contract review
Medicare
Contract law compliance support experience
Finance
Managed care organization experience
5 years
Bachelor's degree in finance
Healthcare Administration
CMS
Contract interpretation
Bachelor's degree in business
Contract performance monitoring
Contract management experience in healthcare
Taxonomy
Finance
CMS regulatory compliance
Bachelor's degree
Health insurance knowledge
Medicare regulations
Requirements analysis
Pricing analysis experience within healthcare industry
Centers for Medicare & Medicaid Services (CMS) billing regulations
Bachelor's degree in healthcare administration
Healthcare financial management
Management reporting
Medicaid regulations

Full Job Description

Payor Contract Manager, Infusion

Hybrid: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The Payor Contract Manager, Infusion manages the operational management, analysis, and administration of payor contracts supporting specialty pharmacy, home infusion, and ambulatory infusion services and ensures that standardized and approved processes are utilized for contract implementation, maintenance, monitoring, and renewal activities to optimize reimbursement, ensure compliance, and support sustainable growth across commercial, Medicare, and Medicaid lines of business.

How you will make an impact:

Manages the lifecycle of payor contracts including review, interpretation, implementation, amendments, and renewals.
Serves as subject matter expert on contract terms including reimbursement methodologies, fee schedules, carve-outs, drug-level pricing, site-of-care requirements, and network participation.
Tracks contract expirations, renewals, and amendments to ensure uninterrupted access and compliance.
Analyzes reimbursement methodologies (AWP, WAC, ASP, MAC, per diem, case rates, nursing fees, supplies, admin fees) and identifies reimbursement risks, underpayments, and revenue leakage.
Partners with finance and revenue cycle to resolve reimbursement discrepancies and payment disputes and supports forecasting, margin analysis, and payor profitability reporting.
Translates contract terms into operational requirements for pharmacy systems, billing platforms, and claim adjudication logic and coordinates with IT and pharmacy operations to ensure accurate setup of pricing and payor-specific rules (including NDC requirements, J-codes, modifiers, and site-of-care billing logic).
Supports payor mapping tied to BIN/PCN, NCPDP, NPI, and taxonomy configurations.
Ensures contracts comply with federal and state regulations including CMS, Medicare Part B and D, Medicaid, 340B, and anti-kickback requirements; maintains audit-ready documentation; and supports internal/external audits.
Acts as the primary contract resource for internal teams; provides contract education to support accurate billing and payor compliance; and supports payor escalations, access issues, and network participation inquiries.

Minimum Requirements:

Requires a Bachelor's degree in Business, Healthcare Administration, Finance, or related field and minimum of 5 years of experience in payor contracting, managed care, or contract administration within specialty pharmacy, infusion pharmacy, PBM, or health plan environments; or any combination of education and experience which would provide an equivalent background.

Primary Posting Location Compensation: MIN $111,132 - MAX $166,698

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

claims manager jobs in forney tx

Payor Contract Manager, Infusion

Storm Restoration Sales & Project Manager | Top first-year performers earn $150K+

TX, RN Certified Case Manager - Workers Compensation

Facility Administrator / Nurse Manager

Manager, Retirement Plans

Civil Engineer Design-Build Leader – Vice President / Principal-in-Charge

Construction Project Manager: Travel

Dental Office Manager/Treatment Coordinator

Heavy Civil Project Manager

Roofing Sales Manager in Training

Roofing Sales Manager in Training

Onsite Manager

Construction Sales Project Manager

Field Claims Manager I

Manager, Claims

Manager Professional Billing & Denial Recovery

RN Manager Home Health Quality Assurance

Manager, Benefit Operations Testing & QA

Registered Nurse (Clinical Nurse Leader) - EDRP Authorized

Program Manager/Training Lead

I want to receive the latest job alert for claims manager in forney tx

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