- Humana (Austin, TX)
- …by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. ... skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge planning… more
- Kelsey-Seybold Clinic (Houston, 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
- Molina Healthcare (Fort Worth, TX)
- **Job Summary** This position is responsible for the holistic management of the external vendor relationships for Claims and Enrollment activities (along with other ... **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including contract negotiation and SLA oversight +… more
- Molina Healthcare (San Antonio, TX)
- …accuracy, completeness, and compliance with Centers for Medicare and Medicaid Services ( CMS ) regulations and guidelines of risk adjustment data * Understand and ... CPC credential **Preferred Education** Bachelor's Degree in Business Administration, Health Care Management o To all current Molina employees: If you are interested… more
- Insight Global (Plano, TX)
- …. Skills and Requirements 3+ years experience in digital content management / communications creation Strong background in digital ... Job Description An employer is looking for a Digital Content / Communications Lead in the Bogota, Colombia area. You... strategy that drive results Hands- on experience with CMS platforms, email tools, and analytics platforms to measure… more
- Broadcom (Plano, TX)
- …codes * Exposure to USS (Unix System Services) * Understanding of SMF ( System Management Facility) data and record formats * Exposure to SMF performance ... especially TPX * Experience working in production mainframe environments * CP and CMS * XEDIT * Experience with REXX, CLIST, or automation scripts * Experience… more
- Baylor Scott & White Health (Round Rock, TX)
- …families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: ... communications with patients & peers, and share best practices from throughout the system . Develop strong working relationships with all team members in the clinic… more
- Gentiva (Amarillo, TX)
- …assessments for the F2F encounter within the regulatory time frames established by CMS + Provides clinical findings, including review of the medical treatment plans, ... diagnostic tests, lab results, and medication lists to the physician who is recertifying the patient for hospice eligibility + Makes appropriate recommendations to the IDG based on findings of the F2F assessment + Notifies hospice agency when unable to… more
- Molina Healthcare (TX)
- …across Medicaid, Medicare, and Marketplace lines of business. This includes direct management of internal teams and external vendors handling both first-pass and ... subrogation case types. + 3+ years of experience in a leadership or management role, including responsibility for both internal staff and vendor oversight. +… more
- ZOLL Medical Corporation (San Antonio, TX)
- …sudden cardiac death. + HFMS (https://cardiacdiagnostics.zoll.com/products/heart-failure-arrhythmia- management - system /) (Heart Failure Management system ... CMS At ZOLL, we're passionate about improving patient...patients suffering from serious cardiopulmonary and respiratory conditions.ZOLL Cardiac Management Solutions offers a unique portfolio of novel technologies… more