• Manager Coding Operations

    Houston Methodist (Houston, TX)
    … classification systems + MS-DRG, APR DRG and APC assignment systems + Official coding guidelines and coding compliance + Working knowledge of medical ... guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and...metrics for assigned area under the direction of the Coding Operations Director . + Ensures that … more
    Houston Methodist (07/18/25)
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  • Manager, Risk Adjustment Coding Support

    Evolent (Austin, TX)
    …addressing regular coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and workflows to enhance department ... Coding Manager plays a crucial role in ensuring accurate medical coding and compliance with risk adjustment models. **What You will Be Doing:** + Hires and… more
    Evolent (09/23/25)
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  • Clinical Compliance Medical Director

    Elevance Health (Grand Prairie, TX)
    **Clinical Compliance Medical Director ** _Please note that per our policy t_ _his role enables associates to work virtually full-time, with the exception of ... unless an accommodation is granted as required by law._ The **Clinical Compliance Medical Director ** is responsible for providing clinical guidance related… more
    Elevance Health (09/24/25)
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  • Director , Prospective + Concurrent Risk…

    Datavant (Austin, TX)
    …experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the ... and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review). You will manage a… more
    Datavant (08/08/25)
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  • Director of Revenue Integrity

    UTMB Health (Galveston, TX)
    …related duties as required. **K** **nowledge/Skills/Abilities:** + Knowledge of CDM, regulatory compliance , ICD-10, and CPT-4 medical record coding and UB04 ... Director of Revenue Integrity **Galveston, Texas, United States**...for all team members. + Maintains knowledge of all compliance regulations, federal and third-party payers that impact revenue… more
    UTMB Health (09/19/25)
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  • Medical Director - Florida

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director ... or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make… more
    Humana (10/03/25)
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  • Medical Director -Payment Integrity

    Humana (Austin, TX)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical… more
    Humana (09/26/25)
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  • Medical Director - Claims Management

    Humana (Austin, TX)
    …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national… more
    Humana (09/17/25)
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  • Director of Payment Integrity Consulting

    CGI Technologies and Solutions, Inc. (Dallas, TX)
    ** Director of Payment Integrity Consulting** **Category:** Finance **Main location:** United States, Georgia, Atlanta **Alternate Location(s):** United States, ... key client stakeholders, including executive leadership, claims operations, finance, compliance , and clinical teams. * Lead client discovery sessions, workshops,… more
    CGI Technologies and Solutions, Inc. (09/25/25)
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  • Director Managed Care Contracting

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Director Managed Care Contracting position is responsible for the development, negotiation, maintenance and payer relations of the Houston ... payment contracts, quality metric bonus program and risk contracts. The Director position responsibilities include overseeing the activities of the department staff,… more
    Houston Methodist (09/12/25)
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