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The Texas Medical Association was organized by 35 physicians in 1853 to serve the people of Texas in matters of medical care, prevention and cure of disease, and the improvement of public health.

DEPARTMENT Health Care Delivery SystemsTITLE: Director, Department of Health Care Delivery SystemsSUPERVISOR: Director, Division of Medical EconomicsBASIC FUNCTIONDeal with the many delivery system issues and problems facing physicians, with an emphasis on health plans in both public and private sectors. Interact with leadership and management of health care delivery systems including physician-directed health care organizations, independent practice associations, free-standing and insurance carrier networks, the Texas Workers Compensation program, and other, related organizations. Observe, analyze and gather data about health care delivery systems, focusing on economic and regulatory dynamics of a rapidly changing health care delivery environment.Build relationships external to the organization to obtain information relevant to physicians regarding health services delivery and insurance carrier/free-standing network operation. Utilize this information to determine how physicians may be impacted by these external forces and delivery systems. Coordinate with TMA staff and others as appropriate to develop policies, products and services and regulatory advocacy which support physicians in the organization and delivery of quality health care services to the citizens of Texas. Work with the Division of Public Affairs to provide legislative advocacy for desired public policy relevant to health care delivery systems.MAJOR RESPONSIBILITIES/TASKS1. Development and presentation of educational talks on health care delivery systems and other issues to County Medical Societies.2. Development and presentation of issue focused talks for TMA sponsored seminars3. Development and delivery of regulatory and legislative advocacy services regarding health care delivery systems and insurance networks in conjunction with the Divisions of Medical Economics and Public Affairs.4. Development of Workers Compensation policy and work with other staff persons within division for Workers Compensation regulatory and legislative advocacy.5. Participating in conference planning meetings, identification of large physician groups and networks, and identifying needs of practice administrators pertaining to health care delivery systems.6. Build relationships with business coalitions in Texas as it pertains to their needs/concerns on provider sponsored networks and other direct contracting entities.7. Function as an ongoing resource to physician members on health care strategy and identification of resources for implementation assistance.8. Lead staff for Council on Health Services organizations and related committees.9. Function as internal resource on health care delivery policy. Provide internal managed health care education to TMA staff.10. Management of existing and future staff as directed.11. Perform other related duties as directed or required. SUPERVISORY RESPONSIBILITYProvides general supervision to a department, makes recommendations regarding hiring/firing, but does not have full responsibility.INDEPENDENCE/SUPERVISION RECEIVEDAssignments are complex and may vary greatly. They require the exercise of independent judgment regarding the definition of basic problems and determination of courses of action to be taken.GENERAL QUALIFICATION REQUIREMENTSKnowledge and Experience:Must have knowledge of the health care marketplace including physicians, hospitals, payers (health care organizations and other), health/regulatory agencies, the Texas legislative process and employers (and other purchasers of services). Should have confidence in presenting information in seminars and other meetings. Experience in working as a team member on intraorganizational and interorganizational projects is important.Skills and Abilities:Must be able to commence and manage multiple initiatives concurrently. Must have excellent interpersonal skills which allow one to interact with individuals internal and external to the Association. Must be able to understand the global vision of the Association and where the Department of Health Care Delivery Systems fits into that vision. Must be able to take global vision and develop appropriate responses (policies, products, services) and implement those as they support the overall vision of the Association.The purpose of a job description is to describe the overall function and general responsibilities of a job. Job descriptions are used in hiring and training and to provide employees with a better understanding of employer expectations. Descriptions are revised as job responsibilities change.

The American Society for Radiation Oncology, ASTRO, seeks an experienced health policy/reimbursement professional to lead the analysis, devekopment and oversight of the Societys response to CMS proposed payment rules; fielding and analyzing physician RUC surveys, developing CPT code change proposals, and supervising work on coding and billing issues. This position involves working closely with our physician volunteers and being able to travel to represent ASTRO at meetings at least 6 times per year. Strong knowledge of the Medicare porgram and physician payment systems is essential. Individual must have strong communication skills, excellent data analysis skills, exceptional interpersonal skills and very strong organizational skills with the ability to multi-task and work under tight time constraints. Knowledge of medical coding strongly preferred. A masters degree in a related field is preferred and 5-7 years of experience in an association or health care related environment. ASTRO offers a competitive salary and excellent benefits package which includes:Flexible work arrangements Medical, dental and vision insurance, majority company paid 401K with immediate company contribution 26 days of Paid Time Off annually On site fitness center Employer paid short and long term disability insurance and morePlease see our website www.astro.org for more information about ASTRO.

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Have Freedom & Find Your Direction Healthcare careers limited only by your dreams.Join Scott & White and discover the benefits of a nationally-recognized healthcare organization with plenty of open doors. Our dedication to leading research, lifelong learning and professional mobility provides you with plenty of ways to reach your ideal destination. The choice is easy. Join us, and believe in your career. Visit www.SW.org today. Customer Resolution Specialist Temple, TX You will provide review/research, direction and coordination for the Scott & White Health Plan in the area of complaints/grievances, redeterminations/reconsiderations and appeals for regulatory compliance. Responsible for daily operations of all required functional components of the process, including reporting/audits, interface with other SWHP operational departments, maintenance of policies and procedures according to regulatory standards and duties supporting the goals and objectives of SWHP. Some travel (up to and > than 100 miles potentially) between sites is required.Requires a Bachelors degree in Nursing or related healthcare field; Masters degree in Nursing or Health Care preferred. If you are an RN or PA, you must be licensed and registered as a professional in Texas. Five to seven years of experience in health care required. Join us, and believe in your career. Scott & White is a fully integrated health system and is the largest multi-specialty practice in Texas, and the sixth largest group practice in the nation. Scott & White employs more than 775 physicians and research scientists who care for patients covering 25,000 square miles across Central Texas. Scott & White has a 636-bed Level I Trauma acute care facility in Temple, an additional 50-bed Long Term Acute Care Hospital in Texas, another 150-bed acute care hospital in Temple, a 76-bed acute care facility in Round Rock (greater Austin area), and a network of 50 primary and specialty clinics throughout the region.Scott & White is an Equal Opportunity Employer | Tobacco-Free Environment.

Have Freedom & Find Your Direction Healthcare careers limited only by your dreams.Join Scott & White and discover the benefits of a nationally-recognized healthcare organization with plenty of open doors. Our dedication to leading research, lifelong learning and professional mobility provides you with plenty of ways to reach your ideal destination. The choice is easy. Join us, and believe in your career. Visit www.SW.org today. Customer Resolution Specialist Temple, TX You will provide review/research, direction and coordination for the Scott & White Health Plan in the area of complaints/grievances, redeterminations/reconsiderations and appeals for regulatory compliance. Responsible for daily operations of all required functional components of the process, including reporting/audits, interface with other SWHP operational departments, maintenance of policies and procedures according to regulatory standards and duties supporting the goals and objectives of SWHP. Some travel (up to and > than 100 miles potentially) between sites is required.Requires a Bachelors degree in Nursing or related healthcare field; Masters degree in Nursing or Health Care preferred. If you are an RN or PA, you must be licensed and registered as a professional in Texas. Five to seven years of experience in health care required. Join us, and believe in your career. Scott & White is a fully integrated health system and is the largest multi-specialty practice in Texas, and the sixth largest group practice in the nation. Scott & White employs more than 775 physicians and research scientists who care for patients covering 25,000 square miles across Central Texas. Scott & White has a 636-bed Level I Trauma acute care facility in Temple, an additional 50-bed Long Term Acute Care Hospital in Texas, another 150-bed acute care hospital in Temple, a 76-bed acute care facility in Round Rock (greater Austin area), and a network of 50 primary and specialty clinics throughout the region.Scott & White is an Equal Opportunity Employer | Tobacco-Free Environment.