• Compliance Analyst (MI Health Plan) - REMOTE…

    Molina Healthcare (TX)
    …monthly and quarterly Key Performance Indicator (KPI) reports. + Support the management of the regulatory memo distribution process Ability to work independently and ... set priorities. + Manages compliance incidents management and related processes, including associated corrective action plans....notices of proposed rulemaking. + Manages user access to CMS . + Analyze data use critical thinking + Ability… more
    Molina Healthcare (07/19/25)
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  • Deputy General Counsel, Litigation - REMOTE

    Prime Therapeutics (Austin, TX)
    …and state regulatory inquiries + Develop and implement litigation and risk management strategies that align with Prime's business objectives, mitigate risk and ... to ensure high-quality representation + Oversee Prime's Records and Information Management (RIM) program, eDiscovery platform, employment law and HR support… more
    Prime Therapeutics (07/19/25)
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  • Physician - Community Based Clinics, Value Based…

    UTMB Health (Friendswood, TX)
    …experience in the management of population health-related programs such as health system management , health plans, or public health or Project or program ... and results of the organization. + Responsible for maintaining the CBC system -wide Quality program; to include data collection, aggregating and analyzing data,… more
    UTMB Health (07/19/25)
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  • Director of Client Success, Payer Risk Adjustment

    Datavant (Austin, TX)
    …to escalate and create solutions. + Own client operations project management processes, tools, reference materials, and cross‐functional usage. + Identify, define, ... to the table:** + Bachelor's degree in Business, Operations Management , or a related field; MBA or equivalent advanced...and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are… more
    Datavant (07/18/25)
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  • Director, Appeals & Grievances (Medicare…

    Molina Healthcare (San Antonio, TX)
    …Plan requirements * Works with Claims, Configuration, Contracting, Provider Data Management , and other business partners to resolve provider concerns related to ... role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims, Surgery, Anesthesia, high dollar complicated claims,… more
    Molina Healthcare (07/18/25)
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  • Clinical Nurse Coordinator - Surgery Center

    HCA Healthcare (Houston, TX)
    …during the designated shift. In collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance ... the unit, in collaboration with other members of the management team. + Collaborates with subject matter experts and...Texas since 1980. Our surgery center is certified by CMS and accredited by AAAHC. We perform over 350… more
    HCA Healthcare (07/18/25)
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  • Lead Technology Product Manager-Commercial Drug…

    Wolters Kluwer (Coppell, TX)
    …market insights into actionable product requirements, collaborates closely with Engineering, Content , and go-to-market teams, and ensures that our solutions meet the ... long-term advocacy. **Cross-Functional Collaboration** * Coordinate with Engineering and Content teams to ensure product requirements are well understood,… more
    Wolters Kluwer (07/18/25)
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  • Supplemental Benefit Program Manager III

    Centene Corporation (Austin, TX)
    …directly responsible for developing the designs annually. Directly responsible for developing CMS filing guides for benefits. Program Manager III is responsible for ... execution, deployment and closure + Utilize corporate and industry standard project management tools and techniques to effectively manage benefit packages + Maintain… more
    Centene Corporation (07/18/25)
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  • Patient Experience Consultant 2 - Hospital

    Baylor Scott & White Health (Mckinney, 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: ... including patient experience metrics. + Partner closely with clinical and system leadership to implement new programs, technologies and strategies to improve… more
    Baylor Scott & White Health (07/18/25)
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  • Behavioral Health - Transfer Center Specialist

    Texas Health Resources (Arlington, TX)
    …You Will Do** + Facilitates behavioral health transfers throughout the THR system and from other healthcare facilities. Documents cases accordingly and meets ... and complies with all regulations including but not limited to TDMHMR, TDH, CMS , EMTALA, and Texas Behavioral Health Marketing Act. Educates hospital staff/ team… more
    Texas Health Resources (07/18/25)
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