- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and ... provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies… more
- CommonSpirit Health (Houston, TX)
- …and quality care management . + Understand the intricacies of the Medicare Inpatient Prospective Payment System (IPPS) to make medical determinations on ... licensed in the state of Texas. As the Utilization Management Physician Advisor (PA), the PA conducts clinical case...respect of medical staff physicians. + In-depth knowledge of CMS regulations, including understanding of the 2-midnight rule. +… more
- Texas Health Resources (Arlington, TX)
- …on police, security, business continuity, physical security risk management , threat management in collaboration with Human Resources, and system emergency ... and execute the overall police, security, business continuity, and system emergency management strategies and program operations...state and federal criminal and civil codes, IAHSS, TJC, CMS / Medicare , OSHA, the State of Texas Commission… more
- Cognizant (Austin, TX)
- …CPT, HCPCS, ICD-9 + Experience with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims + Knowledge of Medicare billing & payment and ... Responsible for reviewing the data in the claim processing system (Facets) and comparing it with the corresponding UB,...Assigned special projects or other duties as determined by management . + Will work closely with other departments **Desired… more
- Cognizant (Austin, TX)
- …ICD-10 * Experience making payments with UB/institutional ( CMS -1450) and/or professional ( CMS 1500) claims * Knowledge of Medicare / Medicaid payment and ... Responsible for reviewing the data in the claim processing system and comparing with corresponding UB or HCFA paper...Assigning special projects or other duties as determined by management . **What you need to have to be considered:**… more
- Gentiva (San Angelo, TX)
- …Perform and complete physical assessments for hospice F2F encounters within CMS -established regulatory timeframes. + Document clinical findings accurately and attest ... Familiarity with LCD criteria and hospice documentation requirements + Knowledge of Medicare , Medicaid, ACHC, and other regulatory guidelines + Strong oral and… more
- HCA Healthcare (Houston, TX)
- …performed more than 100,000 endoscopic procedures. We are certifiedby the Centers for Medicare and Medicaid Services ( CMS ). Also, we have achieved the highest ... level of accreditation by the AccreditationAssociation for Ambulatory Health Care (AAAHC). Physicians Endoscopy Center is a member ofSurgery Ventures powered by HCA Healthcare. HCA Healthcare has been recognized as one of the World's Most Ethical Companies(R)… more
- Amgen (San Antonio, TX)
- …P&T Committee, etc., that act as partners or decision-makers within the Health System Manager assigned accounts + Presents MAC approved data and CV product messaging ... & 2 years of sales experience and/or related account management experience Or Master's degree & 4 years of...CV products and the competition + Functional knowledge of Medicare and Government agencies, as well as abilities that… more
- Prime Healthcare (Weslaco, TX)
- …in the United States in the various areas we serve: + Centers For Medicare & Medicaid Services ( CMS ) Five-Star Quality Rated + LeapFrog Hospital Safety ... (PALS). Responsibilities + The Director is responsible for implementation, ongoing management and strategic growth of the program: outpatient Wound Care Center… more
- Fresenius Medical Center (Brownwood, TX)
- …specific certification as defined by Center for Medicaid/ Medicare ( CMS )Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated ... machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system . **RECORD KEEPING:** + Complete and document ongoing… more