Top 3796 Quality program manager Jobs in Houston, Tx

Provider Contracts Manager
Harris Health —Houston, TX
- $80,000 - $100,000 a year
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- Up to 50% travel
- Health insurance
- Dental insurance
SERVICE SUPPORT MANAGER
Frazer, LTD —Houston, TX
- $80,000 - $110,000 a year
- Overtime
- ERP systems
- Pass drug screening
- Mentoring
- Disability insurance
- Health insurance
Quick Apply
LTCR HCS Manager II
Health & Human Services Comm —Houston, TX
- $7,474.40 - $8,304.83 a month
- Online Application
- Working with individuals with developmental disabilities
- Mid-level
- Office
- Health insurance
- 401(k)
Quick Apply
Quality and Patient Safety Program Manager
St Luke's Sugar Land Hospital —Sugar Land, TX
- $37.40 - $55.63 an hour
- Full-time
- Nursing
- Surgery
- RN License
Contracts Administration Manager
Tyndale —Houston, TX
- $120,000 a year
- Full-time
- Hybrid work
- Microsoft Word
- 7 years
- Microsoft Excel
- Paid parental leave
- Paid holidays
Quick Apply
Provider Contracting Manager
Harris Health —Houston, TX
- $80,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Up to 50% travel
- Health insurance
- Dental insurance
Sr. Program Lead, Professional Education, CKMH
American Heart Association —Houston, TX
- $84,400 - $113,000 a year
- Full-time
- Remote
- 5 years
- Bachelor's degree
- Fair chance
- Wellness program
- Paid holidays
1d
Care Manager
MD Anderson —Houston, TX
- $48.55 - $73.07 an hour
- Overtime
- Remote
- Microsoft Word
- Spanish
- Nursing
- Health savings account
- AD&D insurance
3d
Onsite Food Safety & Quality Ops Manager
PepsiCo —Houston, TX
- $110,700 - $185,250 a year
- Bachelor's degree
- Mentoring
- Fair chance
- Paid parental leave
- Health insurance
Assessment Manager
Harris County Department of Education —Houston, TX
- $72,514 - $88,975 a year
- Full-time
- Writing skills
- Teaching Certification
- Mid-level
RN Case Manager Acute Care
River Oaks Hospital and Clinics —Houston, TX
- $70,000 - $80,000 a year
- Full-time
- Background check
- Spanish
- Nursing
- Disability insurance
- Health insurance
Quick Apply
10d
Pre Op/PACU Manager
Advanced Diagnostics Healthcare System —Houston, TX
- $52,000 - $54,000 a year
- Full-time
- Background check
- Nursing
- Surgery
- Free parking
- Health savings account
Quick Apply
PRECAST CONCRETE PLANT SUPERVISOR
Camp Logan Cement Works Inc. —Houston, TX
- $120,000 - $160,000 a year
- Full-time
- 5 years
- Supervising experience
- Recruiting
- Health savings account
- Health insurance
Quick Apply
10d
Project Manager
Linde —Deer Park, TX
- Full-time
- Background check
- Engineering
- Project management
- Health savings account
- Paid holidays
Quick Apply
11d
Data Integration Lead
Pinnacle —Pasadena, TX
- $130,000 - $175,000 a year
- Extended hours
- Background check
- Office
- Ability to climb stairs
- Free parking
- Health savings account
Quick Apply
2d
Registered Nurse - Case Manager - Southeast Houston
Oak Street Health —Pasadena, TX
- $66,575 - $142,576 a year
- Full-time
- Spanish
- Nursing
- RN License
- Health insurance
- Dental insurance
Case Manager (RN)
Houston Methodist Baytown Hospital —Baytown, TX
- Full-time
- Acute care
- Nursing
- Microsoft Excel
Construction Manager - Residential Construction
Ravenna Homes —Fulshear, TX
- Extended hours
- Construction site
- Customer service
- Writing skills
- Paid holidays
- Health insurance
Quick Apply
Case Manager - Transition in Care
Houston Methodist —Houston, TX
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Outlook
12d
Land Transportation Category Manager
Korn Ferry for SABIC (Saudi Aramco) SMB-RPO —Houston, TX
- $123,000 - $181,000 a year
- Full-time
- Background check
- 18 years or older
- Spanish
- Health insurance
Quick Apply
4d

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quality program manager jobs near houston, tx

Provider Contracts Manager

Harris Health -
Houston, TX

Apply Now

Job Details

Full-time
$80,000 - $100,000 a year

Benefits

Health insurance
Dental insurance
Vision insurance
Prescription drug insurance

Qualifications

Microsoft Outlook
Managed care organization experience
Contract management experience in healthcare
Driver's License
Direct contracting
Relationship management
Contracts
Terms and conditions negotiation

Full Job Description

Job Details

Career area

CHC Professional

Position Type

Full Time

Pay

$80,000.00 - $100,000.00

Location

CHC Loop Central - Remote, Houston, TX 77081, United States

Job ID

178907

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Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

' Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

JOB SUMMARY
The Provider Contracts Manager at Community Health Choice is responsible for network development and management. This role involves expanding provider networks for existing and new lines of business, negotiating provider agreements, ensuring regulatory compliance, and maintaining effective relationships with providers. The Provider Contracts Manager collaborates with various internal departments to achieve departmental goals and contribute to the overall success of the organization.

JOB SPECIFICATIONS AND CORE COMPETENCIES
Negotiate Provider Contracts:
Negotiate contract language and rates with hospital, physician, ancillary, and LTSS providers in accordance with established parameters and guidelines.
Collaborate with Compliance, Legal, and Credentialing teams to finalize
provider contracts, including amendments and new agreements.
Ensure compliance with regulatory and product requirements related to provider contracting, including network adequacy standards.

Expand Provider Networks:
Actively seek opportunities to expand provider networks for existing and new lines of business.
Conduct external meetings with prospective and existing providers to negotiate
or renegotiate agreements.
Collaborate with other relevant teams to facilitate network expansion efforts.

Ensure Compliance and Network Adequacy:
Assure compliance with regulatory requirements and product specifications related to provider contracting functions.
Monitor and ensure network adequacy, making necessary adjustments to meet
regulatory standards.
Coordinate with Network Management, Claims, and Provider Data Integrity teams to ensure accurate contract reimbursement and adherence to requirements.

Contribute to Departmental Goals:
Actively contribute to the achievement of departmental goals as outlined in the annual business plan.
Participate in departmental process improvement initiatives to enhance
operational efficiency and effectiveness.

Provider Relationship Management:
Serve as a liaison between Community Health Choice and its providers, facilitating communication and addressing any issues that arise.
Resolve problems and ensure smooth operations by maintaining positive
relationships with providers.

Other Duties:
Perform other duties as assigned to support the overall functioning of the department.

QUALIFICATIONS:
Education/Specialized Training/Licensure: Bachelor's degree Or
7 years' experience in lieu of degree (Must be the equivalent combination of required education and minimum experience.) required.

Work Experience (Years and Area): Minimum of three (3) years of experience in healthcare, providers/managed care, contracting, and relations with degree.

Minimum of seven (7) years of experience in healthcare, providers/managed care, contracting, and relations without degree.

Management Experience (Years and Area): N/A

Software Proficiencies: Microsoft Office (Word, Excel, Outlook)

Other: Travel will be required 50% of the time. Must have a vehicle and a valid State of Texas Driver's License. Must have managed care contract negotiation experience, preferably in the Houston market. Experience with Star Plus, LTSS, HCBPs, and
Medicare products is a plus.

Apply Now

Refine Your Search

quality program manager jobs in houston, tx

Provider Contracts Manager

SERVICE SUPPORT MANAGER

LTCR HCS Manager II

Quality and Patient Safety Program Manager

Contracts Administration Manager

Provider Contracting Manager

Sr. Program Lead, Professional Education, CKMH

Care Manager

Onsite Food Safety & Quality Ops Manager

Assessment Manager

RN Case Manager Acute Care

Pre Op/PACU Manager

PRECAST CONCRETE PLANT SUPERVISOR

Project Manager

Data Integration Lead

Registered Nurse - Case Manager - Southeast Houston

Case Manager (RN)

Construction Manager - Residential Construction

Case Manager - Transition in Care

Land Transportation Category Manager

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