- Molina Healthcare (TX)
- **Job Description** **Job Summary** Molina Pharmacy Services/ Management staff work to ensure that Molina members, providers, and pharmacies have access to all ... members, providers, pharmacists, pharmacies, and technicians to meet departmental and CMS standards. + Enforce HIPAA compliance standards and regulations while… more
- Molina Healthcare (San Antonio, TX)
- …tasks and projects to ensure Centers for Medicare & Medicaid Services ( CMS ) and State regulatory requirements are met for Pre-pay Edits, Overpayment Recovery ... (CPT), International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Revenue Codes), and federal/state Medicaid payment rules. +… more
- HCA Healthcare (Arlington, TX)
- …healthcare team. **Major Responsibilities:** + Responsible for overall operation and management of the patient tray delivery system . + Responsible ... for ensuring compliance with HACCP guidelines and regulatory standards such as TJC, CMS , etc. + Participates on hospital committees + Oversees Patient Computer … more
- Kelsey-Seybold Clinic (Lake Jackson, TX)
- …of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024. Kelsey-Seybold has been ... recognized by the National Committee for Quality Assurance (NCQA) as the nation's first accredited Accountable Care Organization and a Level 3 (highest) Patient-Centered Medical Home. Kelsey-Seybold has many physicians in the Greater Houston area certified for… more
- Kelsey-Seybold Clinic (Katy, TX)
- …imaging, lab services, patient education and more within the Kelsey-Seybold system . Our Internal medicine physicians also interpret basic medical tests and ... patient care which is important for collaboration across the system . At Kelsey-Seybold Clinic, you will see patients in...as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024.… more
- Kelsey-Seybold Clinic (Pasadena, TX)
- …of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024. Kelsey-Seybold has been ... recognized by the National Committee for Quality Assurance (NCQA) as the nation's first accredited Accountable Care Organization and a Level 3 (highest) Patient-Centered Medical Home. Kelsey-Seybold has many physicians in the Greater Houston area certified for… more
- Kelsey-Seybold Clinic (Sugar Land, TX)
- …of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024. Kelsey-Seybold has been ... recognized by the National Committee for Quality Assurance (NCQA) as the nation's first accredited Accountable Care Organization and a Level 3 (highest) Patient-Centered Medical Home. Kelsey-Seybold has many physicians in the Greater Houston area certified for… more
- Elevance Health (Grand Prairie, TX)
- …PRIMARY DUTIES: + Review medical record documentation in support of Evaluation and Management CPT codes. + Reviews company specific, CMS specific, and competitor ... code for coverage, policy, reimbursement development, and implications for system edits. + Coordinates research and responds to ...system edits. + Coordinates research and responds to system inquiries and appeals. + Conducts research of claims… more
- CenterWell (San Antonio, TX)
- …The Quality RN Professional is responsible for the development, implementation and management oversight of the Primary Care Organization's Stars Program in the Rio ... the scope of provider relationships across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational… more
- Kelsey-Seybold Clinic (Richmond, TX)
- …of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024. Kelsey-Seybold has been ... recognized by the National Committee for Quality Assurance (NCQA) as the nation's first accredited Accountable Care Organization and a Level 3 (highest) Patient-Centered Medical Home. Kelsey-Seybold has many physicians in the Greater Houston area certified for… more