8 Texas Health Resources jobs in the United States

Market Relations Department is looking for top skilled Payor Analyst. Is that you?

Work location: Hybrid: Southwestern Health Resources Headquarters, 1601/1603 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234.

Work environment: Market Relations

Work hours:

• Full-time, 40 hours per week.

• Monday - Friday, Day shift.

• This is a Hybrid position, to be based in North Texas/Dallas-Fort Worth area, requiring occasional onsite workdays, based on department business needs.

• In-person attendance required at department meetings, trainings and/or other department authorized activities, at the above-mentioned address or other locations as directed by the department management.

At Southwestern Health Resources (SWHR), we believe healthcare can be more integrated, accessible, and affordable for all. Our purpose is simple yet powerful: to build a better way to care, together. SWHR is a patient-centered, clinically integrated network that brings together academic and community clinicians, researchers, hospitals, and ambulatory facilities. We partner with physicians to drive a new model of value-based, high-quality, data-driven healthcare—serving everyone in the communities we touch. By combining the strengths of UT Southwestern Medical Center and Texas Health Resources, we've built the largest provider network in North Texas, giving our team members the opportunity to make a meaningful impact at scale. Healthcare in the U.S. is evolving rapidly, and SWHR is committed to leading that change—moving healthcare forward, together.

What You Will Do:

Assists the Managed Care Director with the following:

Contract management support:
Review and interpret payor contracts to understand contract language, reimbursement rates, billing rules and other relevant items of the contract.
Assist with maintaining contract language key terms by payor tracking grid.
Prepare routing documents for new contracts and amendments.
Review and redline low-level amendments (e.g., term extensions, facility listing updates) and regulatory exhibits (Texas, Medicare, Medicaid).
Complete and distribute New Contract Orientation forms and communications to internal stakeholders.
Maintain organized records of contract status, amendments, and stakeholder communications.
35%
Claims Project management:
Maintain claim project tracker by payor (e.g., Aetna, BCBSTX, Cigna, UHC) and monitor project status.
Participate in payor claim calls, identify claim trends, work with payors to resolve issues and document outcomes.
Escalate unresolved claims to appropriate parties and follow through to resolution.
Maintain and update claim project trackers, ensuring alignment with internal stakeholders and timelines.

20%
Payor Policy & Procedure Update management:
Interpret and communicate payor policy changes to internal stakeholders, ensuring compliance and accurate billing practices.
Review daily updates from Policy Reporter to identify changes with potential financial impact.
Collaborate with analysts to assess the financial implications of policy changes for internal stakeholders.
Notify payors of significant impacts within required timeframes and monitor resolution status.
Document and communicate policy changes and outcomes to relevant internal teams.

10%
Managed Care Projects/Payor Queries:
Support cross-functional managed care initiatives and respond to payor-related queries.
Communicate with payors, internal stakeholders (billing, coding, clinical), and others to resolve issues and improve processes.
Collect, organize, and present data in a clear and actionable format.
Provide timely updates and final reports to requesting departments or leadership.
Ensure all project documentation is complete, accurate, and accessible.

30%
Committee Participation
Represent the Managed Care team in internal and external meetings, committees, and workgroups.
Actively participate in discussions, share insights, and contribute to strategic planning efforts.
Build and maintain strong relationships with payors and internal departments to support collaborative problem-solving.
10%

Education Bachelor's Degree Business or Healthcare 4 Years Req Or
Master's Degree Business or Healthcare Pref

Experience 4 Years 4 Years of Experience in managed care, payor relations, or healthcare operations Req

Skills Familiarity with healthcare payor systems and contract language.
Experience with policy impact analysis and claims resolution.
Ability to work independently and collaboratively in a fast-paced environment.
Excellent project management and problem-solving skills.
Detail-oriented.
Strong analytical skills.
Excellent oral and written communication skills.

Supervision Individual Contributor

Budget Responsibility Primary Budget Responsibility Less than $100 Thousand $80k - 110K

ADA Requirements Working Indoors 67% or more

Physical Demands Sedentary

Risk Adjustment Department is looking for top skilled Education Specialist. Is that you?

Work location: Southwestern Health Resources Headquarters, 1601/1603 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234.

Work environment: Risk Adjustment Department.

Please note: The Education Specialist will be an employee of Southwestern Health Resources (SWHR). SWHR is a clinically integrated network formed by Texas Health Resources (THR) and University of Texas Southwestern Medical Center (UTSW).

Work hours:

• Full-time, 40 hours per week.

• Monday - Friday, Day shift.

• This is a Hybrid position, requiring onsite workdays during the week, based on department business needs.

• Require travel, approximately 80%, to Provider locations, within the Greater Dallas/Fort Worth Metroplex and surrounding areas, based on department business needs.

• In-person attendance required at department meetings, trainings and/or other department authorized activities, at the above-mentioned address or other locations as directed by the department management.

At Southwestern Health Resources (SWHR), we believe healthcare can be more integrated, accessible, and affordable for all. Our purpose is simple yet powerful: to build a better way to care, together. SWHR is a patient-centered, clinically integrated network that brings together academic and community clinicians, researchers, hospitals, and ambulatory facilities. We partner with physicians to drive a new model of value-based, high-quality, data-driven healthcare—serving everyone in the communities we touch. By combining the strengths of UT Southwestern Medical Center and Texas Health Resources, we've built the largest provider network in North Texas, giving our team members the opportunity to make a meaningful impact at scale. Healthcare in the U.S. is evolving rapidly, and SWHR is committed to leading that change—moving healthcare forward, together.

What You Will Do:

Responsible for providing Risk Adjustment education, chart review, and training to assigned practices must be willing to travel onsite. Rely upon independent judgment and decision-making at provider sites, whether conducting chart review or providing training/education, both for historical and/or real time data . 20%
Responsible for the collection and analysis of qualitative and quantitative data as it relates to Risk Adjustment specifically around prevalence and suspects . 20%
Contributes to the design and development of ad hoc reports and presentations for Risk Adjustment initiatives . 15%
Acts as Risk Adjustment documentation and coding expert, monitoring and answering questions for assigned clinics. Provides an instructional review of ICD-10-CM translations specific to Medicare Risk Adjustment coding. Responsible for identifying and influencing adoption of resources and processes to reach risk adjustment and quality goals of assigned . 10%
Develop and maintain strong working relationships with assigned SWHR clinic partners, including providers and support staff. 5%
Develops physician and staff remediation plans. 5%
Conduct audits on vendor coding platforms. 5%
Responsible for tracking, scheduling, and coordinating all education services, including onboarding activities for Risk Adjustment coding and documentation. Monitor education programs, timelines, and learner progress and report to leadership when appropriate. 5%
Meet with RAF leadership to partner on the Physician Risk Education Strategy . 10%
Speak and present at outreach events, and other duties as assigned. 5%

What You Need:

Education
H.S. Diploma or Equivalent Req Or
Associate's Degree Pref

Experience
3 Years Risk Adjustment Coding and Auditing or related experience Req and
1 Year Prior Coding Education Pref

Licenses and Certifications
CPC - Certified Professional Coder with credentialing from AHIMA and/or AAPC (RHIT, RHIA, CAC, CPC, CPC-A, COC, CPC-P, CCS) Upon Hire Req Or
Other CRC-Certified Risk Coder from AAPC Upon Hire Req

Department Highlights:

• Educator-Focused Culture : Join a team that values knowledge-sharing, clinical accuracy, and continuous learning to support providers and coding professionals.
• Impactful Audit Work : Play a key role in ensuring documentation integrity and risk adjustment accuracy through proactive auditing and real-time feedback.
• Provider Collaboration : Partner directly with physicians, APPs, and clinical teams to educate on documentation best practices and evolving CMS/HCC guidelines.
• Innovation & Strategy : Contribute to strategic education programs, pilot initiatives, and coding accuracy projects that support ACO REACH and Medicare Advantage models.
• Professional Growth : Expand your skills through access to ongoing training, certifications, cross-functional collaboration, and leadership development opportunities.

Experience 3 Years Risk Adjustment Coding and Auditing or related experience Req and
1 Year Prior Coding Education Pref

Licenses and Certifications CPC - Certified Professional Coder with credentialing from AHIMA and/or AAPC (RHIT, RHIA, CAC, CPC, CPC-A, COC, CPC-P, CCS) Upon Hire Req Or
Other CRC-Certified Risk Coder from AAPC Upon Hire Req

Skills Strong knowledge of Microsoft Office products (Word, Excel, PowerPoint, etc.)
Excellent analytical, organizational, and time management with the added ability to present information in front of groups of people.
Thorough knowledge of CMS Medicare Advantage documentation/submission policies and ICD-10-CM coding guidelines.
Ability to manage multiple tasks and projects and forge strong working relationships.
Ability to communicate clearly and effectively, both orally and in writing.

Supervision Individual Contributor

ADA Requirements Extreme Heat 1-33%
Extreme Cold 1-33%
Extreme Swings in Temperature 1-33%
Extreme Noise 1-33%
Working Outdoors 1-33%
Working Indoors 67% or more
Mechanical Hazards 1-33%
Electrical Hazards 1-33%
Explosive Hazards 1-33%
Fume/Odor Hazards 1-33%
Dust/Mites Hazards 1-33%
Chemical Hazards 1-33%
Toxic Waste Hazards 1-33%
Radiation Hazards 1-33%
Wet Hazards 1-33%
Heights 1-33%
Other Conditions 1-33%

Physical Demands Sedentary

Southwestern Health Resources is looking for a highly skilled Program Manager. Is that you?

Work location: Southwestern Health Resources Headquarters , Hybrid: 1601 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234.

Work environment: Patient Experience and Clinical Safety

Position Summary:

The Program Manager, Patient Experience & Clinical Safety, is a highly skilled professional responsible for managing and coordinating integrated patient experience and clinical safety initiatives across our clinically integrated network. This role primarily focuses on enhancing the patient's journey while incorporating essential clinical safety elements as they interrelate with and impact patient experience and overall quality performance. The Program Manager will focus on network-wide initiatives, collaborating across the clinically integrated network and its comprehensive care settings to synergize the patient's experience and journey, and influencing success through effective relationships with various leaders and counterparts. This position requires a blend of analytical skills, clinical understanding, and exceptional interpersonal abilities to drive measurable change within the healthcare environment. This role also encompasses providing functional guidance and oversight to assigned program personnel, ensuring the effective execution of program objectives and the enhancement of the patient journey.

Work hours:

• Full-time, 40 hours per week.

• Monday - Friday, Day shift.

• This is a Hybrid position: expectation to work onsite at least once per week.

• In-person attendance required at department meetings, provider and staff trainings and/or other department authorized activities, at the above-mentioned address or other locations as directed by the department management.

Organization Highlights

At Southwestern Health Resources (SWHR), we believe healthcare can be more integrated, accessible, and affordable for all. Our purpose is simple yet powerful: to build a better way to care, together. SWHR is a patient-centered, clinically integrated network that brings together academic and community clinicians, researchers, hospitals, and ambulatory facilities. We partner with physicians to drive a new model of value-based, high-quality, data-driven healthcare—serving everyone in the communities we touch. By combining the strengths of UT Southwestern Medical Center and Texas Health Resources, we've built the largest provider network in North Texas, giving our team members the opportunity to make a meaningful impact at scale. Healthcare in the U.S. is evolving rapidly, and SWHR is committed to leading that change—moving healthcare forward, together.

What You Will Do:

• Patient Experience Program Management: Manage and coordinate assigned multi-disciplinary, cross-departmental projects focused on enhancing patient experience across the network. This includes overseeing CAHPS, post-visit patient surveys, and other patient feedback programs, analyzing patient experience data trends, and developing provider education initiatives related to patient-centered communication and service excellence.

• Patient Feedback & Insights: Design, implement, and manage patient feedback mechanisms to gather insights and identify improvement opportunities.

• Patient Communication & Engagement: Lead efforts to enhance communication clarity and empathy and support the implementation of patient engagement strategies.

• Interrelated Clinical Safety Support: Support clinical safety initiatives that directly impact patient experience and quality outcomes, including assisting in the review of safety events, identifying contributing factors, and supporting the development and implementation of corrective actions.

• Documentation & Workflow Improvement: Collaborate with appropriate teams to identify and address clinical documentation gaps in the EHR (Electronic Health Record) that impact care quality, patient safety, and care gap closure, and support the implementation of EHR solutions aimed at improving patient care.

• Quality Improvement Project Execution: Execute and manage patient experience and related clinical safety improvement projects utilizing established quality improvement methodologies (e.g., Model for Improvement, Lean, Six Sigma, PDSA cycles), driving measurable improvements in outcomes.

• Data Analysis, Reporting & Benchmarking Support: Collaborate with analytics partners to establish, monitor, and report on key performance indicators (KPIs) for patient experience and relevant clinical safety metrics. Utilize benchmarking data to identify opportunities for improvement and prepare and present findings to leadership. This includes the ability to translate data confidently, defend its validity, and recommend actionable next steps.

• Value-Based Care Performance Insights: Provide subject matter expertise and insights to help inform discussions related to how patient experience impacts value-based care contract performance. Contribute to the development of ROI models for patient experience programs and educate internal and external stakeholders on the financial and quality impacts of experience performance.

• Network Synergy & Collaboration: Collaborate with leaders and counterparts across the network to synergize the patient experience and journey, motivating and influencing positive changes in diverse care settings.

• Program Personnel Guidance : Provide functional guidance, mentorship, and support to individuals assigned to support program initiatives, fostering their professional development and ensuring alignment with program goals.

• Work Coordination: Coordinate and oversee tasks for assigned program personnel, ensuring timely completion and adherence to program standards and objectives.

• Collaborative Support : Collaborate with contributing staff to address challenges, share best practices, and facilitate their growth in support of overall program success.

Education
Bachelor's Degree Healthcare Administration, Public Health, Nursing, or a related clinical or administrative field Required Or
Master's Degree Related field Preferred

Experience
5 Years Experience in healthcare delivery, with a strong focus on patient experience program management and/or quality improvement, including exposure to clinical safety principles. Required

Licenses and Certifications
Other CPXP - Certified Professional in Patient Experience Upon Hire Preferred And
CPPS - Certified Professional in Patient Safety Upon Hire Preferred
PMP - Project Management Professional Certification Upon Hire Preferred
SSLP - Six Sigma Lean Professional Upon Hire Preferred
SSGBC - Six Sigma Green Belt Certification Upon Hire Preferred

Skills

• Strong communication skills (verbal and written) needed to interact professionally and effectively in the work environment, including the ability to navigate difficult conversations successfully.
• Demonstrated self-awareness, accountability, and resilience, with the ability to calmly navigate challenging situations and take initiative to move forward.
• Strong analytical and problem-solving skills, with the ability to interpret data and identify trends related to patient experience and its impact on quality.
• Demonstrated ability and skills with project coordination and quality improvement tools, such as Microsoft Excel, or SharePoint.
• Excel lent organizational and time management skills, with the ability to adapt to changing priorities, manage numerous diverse projects simultaneously, and meet deadlines.
• Familiarity with quality improvement methodologies, such as Lean or PDSA.

  Supervision
  This position manages people

  ADA Requirements
  Working Indoors 67% or more

  Physical Demands
  Sedentary