• Physician - Palliative Care

    Kelsey-Seybold Clinic (Webster, TX)
    …and to improve the efficiency and effectiveness of resources + Ensure compliance with legal, regulatory, and clinical policies and procedures **Essential Duties and ... Prescribe medications including controlled substances + Order treatments and durable medical equipment as indicated + Perform other therapeutic or corrective… more
    Kelsey-Seybold Clinic (06/05/25)
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  • Director Managed Care Contracting

    Houston Methodist (Houston, TX)
    …care payers include commercial payers, separate transplant contracts, Medicare Advantage, Medicaid Health Maintenance Organizations (HMOs), International, behavioral ... for employee engagement, adequate staffing levels, budget development and compliance , staffing decisions such as hiring and terminating employment, coaching… more
    Houston Methodist (07/03/25)
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  • Senior Business Intelligence Engineer

    Humana (Austin, TX)
    …in reporting tools such as SSRS or SSIS + Knowledge of Medicaid or Medicare services + Advanced data analytics skills and reporting experience to include working ... Science, Statistics, or related field + Experience working with Medicaid and Medicare data + Expertise in creating analytics solutions to drive decision making… more
    Humana (08/26/25)
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  • Lead Product Manager - Dual Population

    Humana (Austin, TX)
    …best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various multi-disciplinary ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager sits in...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
    Humana (08/23/25)
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  • Licensed Clinical Social Worker

    Kelsey-Seybold Clinic (Shenandoah, TX)
    …providers to assist in the management of psychosocial problems interfering with compliance and other treatment regimens. The therapist will conduct evaluations and ... practice, founded in 1949 by Dr. Mavis Kelsey in Houston's renowned Texas Medical Center. More than 850 physicians and allied health professionals practice at over… more
    Kelsey-Seybold Clinic (07/08/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (TX)
    …you. **Requirements:** + **5 years recent experience in acute-care Inpatient facility-based medical coding (clearly reflected in your attached resume);** + **DRG and ... knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS-DRG),All Payer Group (APR-DRG) and Ambulatory Payment… more
    Banner Health (08/30/25)
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  • Encounter Data Management Professional

    Humana (Austin, TX)
    …have comprehensive knowledge of processes, policies and procedures as well as compliance guidelines. Will support achieving operational and compliance key ... to make an impact** **Required Qualifications** + Minimum 1 year of experience in medical claims payment and processing + Minimum 1 year of experience analyzing and… more
    Humana (08/16/25)
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  • Clinical Reviewer, Nurse-Surgery

    Evolent (Austin, TX)
    …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... and management staff, other CR's (Clinical Reviewers), providers, office staff and Field Medical Directors. **What You Will Be Doing:** + Functions in a clinical… more
    Evolent (08/19/25)
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  • Utilization Management Dental Director- Texas

    Humana (Austin, TX)
    …implementation of appropriate policies, protocols, and procedures which are in compliance with the most current accepted professional standards. o Provides dental ... the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. o Review dental… more
    Humana (08/23/25)
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  • Field Reimbursement Manager (Immunology…

    J&J Family of Companies (Dallas, TX)
    …support needs. + Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS. Serve as subject matter expert ... access and affordability solutions across multiple payer types and plans (ie, Medicare , Medicaid Managed Care, Commercial). + Execute business in accordance with the… more
    J&J Family of Companies (08/25/25)
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