Plan Design Specialist jobs in Fort Worth, TX

Plan Design Specialist works closely with clients to design group health, dental and/or life insurance plans to create an overall benefit package. Works alongside underwriters, but is not an underwriter role. Being a Plan Design Specialist monitors and analyzes cost trends. May handle more complex plan design. Additionally, Plan Design Specialist requires a bachelor's degree or its equivalent. Typically reports to a supervisor or manager. The Plan Design Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Plan Design Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

Recently Added Plan Design Specialist jobs

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Health Plan Liaison & Insurance Contrast Specialist
  • Complete Care ER
  • Southlake, TX FULL_TIME
  • Full-time Health Plan Liaison & Insurance Contract Specialist -
    Southlake, Texas
    **This is an onsite position only, not remote.**
    Must have a minimum of three years healthcare industry experience, with an emphasis on contract negotiation and administration, required.
    Must have an In-depth knowledge of revenue codes, CPT codes, and HCPCS codes

    We are looking for our next SUPER STAR! As a Payor Relations & Contract Specialist at Complete Care, you will be responsible for implementing policies, negotiating rates, and language terms with regard to provider enrollment with insurance plans and managed care contracting. If you are looking to join an award winning company with a great work environment and friendly outgoing co-workers then keep reading.
    About us
    Complete Care values the role each member of our team plays in helping provide award winning care to the communities we serve. We employ more than 500 people and provide rewarding career opportunities that help them reach their highest potential. You’ll be recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role.
    Our company has been industry pioneers since 2009. We have been recognized year after year by receiving the prestigious Press Ganey Pinnacle as well as the Guardian of Excellence award for patient satisfaction.
    “The only way to earn the accolades we’ve received is to hire great people and give them the tools to succeed. I am fortunate to be surrounded by a very talented team. When people take pride in their work and love their job, extraordinary things can happen” –Rob Morris, CEO

    RESPONSIBILITY:
    • Collaborate with leadership, identify appropriate contracting and re-contracting opportunities.
    • Initiates discussions with key constituents as related to new relationships or service lines.
    • Performs business and market analysis to determine viability of contracting.
    • Ensures contracting efforts remain aligned with company goals; contract terms can be administered and monitored in a cost-effective manner.
    • Collaborates with payors and internal stakeholders to gain a thorough understanding of payer-specific requirements, reimbursement logic, and limitations.
    • Leads contract discussions with managed care organizations, including rate and language negotiations in accordance with established guidelines. Leads development of rate and language proposals.
    • Collaborates with internal staff on modeling of rate proposals.
    • Confidently make sound recommendations to leadership for accepting/rejecting proposed managed care agreements.
    • Effectively interfaces with management, clinical, operations, and administrative staff to ensure contract negotiations are completed in accordance with critical dates and within approved financial parameters.
    • Manages all aspects of the contract life-cycle; reviews and evaluates contract language and reimbursement terms.
    • Updates and models with new contract and reimbursement terms using proprietary software applications and MS Office tools.
    • Collaborates to assemble and gain an understanding of payer specific data, operational issues, and business review.
    • Prepares financial analyses and reports.
    • Implements executed contracts cross-functionally, communicates contract changes internally, maintains appropriate documentation, reviews contract performance reports and makes appropriate recommendations.
    • Facilitates problem solving of escalated contractual and operational issues through collaboration with managed care organizations and internal stakeholders.
    • Identifies and communicates opportunities for process improvement with managed care organizations and internal stakeholders.
    • Coordinates with analytical team to ensure contractual terms, including payer-specific requirements, reimbursement logic, and limitations are understood and appropriately included in any modeling systems.
    • Serves as the expert on all terms of the payer contract for both internal and external parties.
    • Participates in special projects as needed, including evaluating feasibility of program development as it pertains to payer operational requirements and reimbursement policies
    • Stays abreast of changing healthcare landscape to maintain an awareness of competitor services and reimbursement models, as well as opportunities for improvement in the financial and operational components of managed care contracts.
    • Leads discussions pertinent to contract performance, market changes, market intelligence, and strategic decision making.
    • Performs miscellaneous job related duties as requested.
    MINIMAL REQUIREMENTS:
    • High school diploma required; Associates Degree preferred.
    • Minimum three years of healthcare industry experience, with an emphasis on contract negotiation and administration, required.
    • In-depth knowledge of revenue codes, CPT codes, and HCPCS codes
    • Proficient in Microsoft Excel, Word, Outlook, PowerPoint and Internet
    • Excellent written and oral (presentation) skills.
    • Strong analytical and project management skills.
    • Ability to work both independently and in a dynamic team environment with rapidly changing priorities and demands.
    • Ability to prioritize and handle multiple tasks in a demanding work environment.
    • Demonstrated organizational skills. Ability to work effectively under deadlines and produce accurate work.
    • Ability to communicate complex issues effectively.
    • Demonstrated ability to drive results and take initiative.
    • Strong understanding of the insurance environment, including, but not limited to, insurance policies and procedures, reimbursements mechanisms, billing principles, and practice management/medical office procedures.
    • Maintain confidentiality and privacy is a must.

    #PayorRelations
    #CompleteCare
    #ContractSpecialist
    #SouthlakeTexas
  • 29 Days Ago
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Communications and Graphic Design Specialist
  • University of North Texas Health Science Center
  • Fort Worth, TX FULL_TIME
  • Position Information UNT System Overview Welcome to the University of North Texas System. The UNT System includes the University of North Texas in Denton and Frisco, the University of North Texas at D...
  • 6 Days Ago
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Communications and Graphic Design Specialist
  • University of North Texas Health Science Center
  • Fort Worth, TX FULL_TIME
  • Position Information UNT System Overview Welcome to the University of North Texas System. The UNT System includes the University of North Texas in Denton and Frisco, the University of North Texas at D...
  • 6 Days Ago
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Instructional Design Specialist
  • Tarrant County College
  • Fort Worth, TX FULL_TIME
  • F006058 Position Status Full Time Assignment Length This field only applies to Faculty Grant Funded No Category APT Class Code 14 Starting Pay $66,951 Special Note Commensurate with education and expe...
  • 7 Days Ago
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ONSITE - Plan Administration Specialist - Fort Worth, TX 76102, USA
  • TEKsystems
  • Fort Worth, TX FULL_TIME
  • Description:Act as liaison for clients and all parties related to the funding transaction.Perform multi-step review of documents received by clients Complete, submit, and follow up with account applic...
  • 19 Days Ago
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Property Preservation Specialist
  • Mortgage Specialist International
  • Fort Worth, TX FULL_TIME
  • Our Property Preservation Specialist is the primary point of contact for our Client(s). Our Client Management department is seeking a qualified candidate to fill our Property Preservation Specialist r...
  • 26 Days Ago
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0 Plan Design Specialist jobs found in Fort Worth, TX area

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E-Commerce Marketing Associate (Analytical) (Hybrid Remote) (Entry-Level)
  • Reli.
  • Fort Worth, TX
  • Reli. is a rapidly growing eCommerce company selling on Amazon (www.amazon.com/reli), Walmart, Shopify (ShopReli.com), a...
  • 4/24/2024 12:00:00 AM
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Sales Account Manager
  • Burkhart Dental Supply
  • Fort Worth, TX
  • We are looking for a Sales Account Manager in Fort Worth, TX. This is for a scratch territory, so the ideal candidate wo...
  • 4/24/2024 12:00:00 AM
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Practice Technology Developer | Computational Design
  • Corgan
  • Dallas, TX
  • Overview: Corgan, a leading global architecture and interior design firm, is seeking qualified candidates for the role o...
  • 4/24/2024 12:00:00 AM
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Internal Revenue Agent - 12 Month Roster
  • Department Of The Treasury
  • Fort Worth, TX
  • Duties WHAT IS THE LARGE BUSINESS AND INTERNATIONAL(LB&I)DIVISION? A description of the business units can be found at: ...
  • 4/24/2024 12:00:00 AM
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Principal Claims Specialist
  • Alcon
  • Fort Worth, TX
  • At Alcon, we are driven by the meaningful work we do to help people see brilliantly. We innovate boldly, champion progre...
  • 4/24/2024 12:00:00 AM
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Sales Lead
  • Visionworks
  • Fort Worth, TX
  • About Us:Want to bring the 'care' back to the vision care industry? We're looking for charismatic types who are ready to...
  • 4/24/2024 12:00:00 AM
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Roadside Safety Services Specialist
  • North Texas Tollway Authority
  • Fort Worth, TX
  • Job Description Job Description The North Texas Tollway Authority has been connecting North Texans for 25 years, serving...
  • 4/24/2024 12:00:00 AM
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Event Team Member
  • Closet Factory Inc
  • Dallas, TX
  • As an Event Team Member at Closet Factory-DFW, you will be joining ***a team that respects, appreciates, and rewards har...
  • 4/21/2024 12:00:00 AM
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About Fort Worth, Texas

Fort Worth is located in North Texas, and has a generally humid subtropical climate. It is part of the Cross Timbers region; this region is a boundary between the more heavily forested eastern parts and the rolling hills and prairies of the central part. Specifically, the city is part of the Grand Prairie ecoregion within the Cross Timbers. According to the United States Census Bureau, the city has a total area of 349.2 square miles (904 km2), of which 342.2 square miles (886 km2) is land and 7.0 square miles (18 km2) is covered by water. It is a principal city in the Dallas–Fort Worth metropl...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Plan Design Specialist jobs
$72,114 to $97,739
Fort Worth, Texas area prices
were up 2.2% from a year ago
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What does a Plan Design Specialist do?

Plan Design Specialist in Birmingham, AL
SmithGroup creates exceptional design solutions for healthcare, science and technology organizations, higher education and cultural institutions, urban environments, diverse workplaces, mixed-use and waterfront developments, and parks and open spaces.
December 13, 2019