• Case Management Representative

    Houston Methodist (Cypress, TX)
    …and coordination as needed **FINANCE ESSENTIAL FUNCTIONS** + Informs social worker/ case manager of the patients' available benefits through insurance/managed ... At Houston Methodist, the Case Management Representative position is responsible for providing...Assists the department in distributing required notices, including the Medicare Notice of Discharge to patients, securing signatures on… more
    Houston Methodist (08/16/25)
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  • Sr. Specialist, Member & Community Intervention…

    Molina Healthcare (Austin, TX)
    …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with… more
    Molina Healthcare (06/19/25)
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  • Non-Clinical Coding and OASIS Review…

    BAYADA Home Health Care (Austin, TX)
    …for quality and adherence to policies and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role are expected to ... is hiring a full time OASIS Review and Coding Manager . The OASIS and Coding Review Manager ... provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and Assessment Information… more
    BAYADA Home Health Care (08/15/25)
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  • RN Care Manager Remote with field travel…

    Molina Healthcare (Austin, TX)
    …with Medicare /Medicaid, MS 365 and familiarity with claims is highly preferred. The Case Manager must be able to work in a high-volume environment. Bilingual ... behavioral health settings. Preferred License, Certification, Association Active, unrestricted Certified Case Manager (CCM) To all current Molina employees: If… more
    Molina Healthcare (08/08/25)
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  • Payment Integrity Subrogation Manager

    Molina Healthcare (TX)
    **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid, Medicare , and ... role requires experience across a wide range of subrogation case types-including automobile-related claims (eg, no-fault/PIP), workers' compensation, general… more
    Molina Healthcare (07/23/25)
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  • Field Care Manager , Ltss (RN)

    Molina Healthcare (TX)
    …waiver services. **Preferred License, Certification, Association** Active and unrestricted Certified Case Manager (CCM) To all current Molina employees: If ... licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area;...enrollment and disenrollment processes. + Develops and implements a case management plan, including a waiver service plan, in… more
    Molina Healthcare (07/20/25)
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  • Delivery Senior Manager

    NTT America, Inc. (Plano, TX)
    …adaptable, and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a ** ... Medicare Appeals Clinical Leader** to lead service delivery engagements...performance, metrics, and processes. + Track appeal metrics, including case volumes, resolution times, and denial rates. + Analyze… more
    NTT America, Inc. (06/12/25)
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  • Clinical Manager RN Sign On Bonus

    HCA Healthcare (San Antonio, TX)
    …bonus - up to $10,000 Do you have the career opportunities as a Clinical Manager RN you want with your current employer? We have an exciting opportunity for you ... colleagues. Do you want to work as a Clinical Manager RN where your passion for creating positive patient...and performance of assigned home health care team(s)Supervises ongoing case management of all patients ensuring an accurate evaluation… more
    HCA Healthcare (06/21/25)
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  • Senior Client Coding Project Manager

    Datavant (Austin, TX)
    …to realize our bold vision for healthcare. As a Sr. Client Coding Project Manager , you will plan, forecast, and manage client-facing coding projects. You will work ... up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
    Datavant (06/28/25)
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  • Clinical Manager , Home Health

    CenterWell (Eastland, TX)
    …of our caring community and help us put health first** The **Clinical Manager ** coordinates and oversees all direct care patient services provided by clinical ... the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including… more
    CenterWell (08/15/25)
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