• Lead Director Network Platform Solutions

    CVS Health (Austin, TX)
    …Examples include ensuring data standards are synchronized across Medicaid and Medicare platforms, ensuring duals workflows are support across systems, ensuring duals ... and Key Performance Indicators are met, mange ad-hoc requests, and ensure compliance with regulatory requirements. + Demonstrate an ability to lead through influence… more
    CVS Health (08/24/25)
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  • Senior Analyst, Quality Management

    CVS Health (Austin, TX)
    …to the development and execution of HEDIS strategy to ensure compliance and optimize performance in quality measurement initiatives. Responsibilities include: * ... data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to regulators, including… more
    CVS Health (08/24/25)
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  • Manager, Coding & QA Clinical - Revenue Cycle…

    UTMB Health (Galveston, TX)
    …internally within the Revenue Cycle as well as throughout the institution to ensure compliance with all Federal and State-mandated billing and coding laws. The ... Director of Coding, actively manages Clinical coding operations for UTMB to promote compliance with Federal , state and hospital documentation, coding and billing… more
    UTMB Health (08/08/25)
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  • Director of Hospital Accounts Receivable

    UTMB Health (Galveston, TX)
    …internally within Revenue Cycle as well as throughout the Enterprise to ensure compliance with all Federal and State-mandated billing and cash collection laws. ... the accurate and timely billing of Hospital accounts in compliance with all State and Federal guidelines....System experience. **Knowledge, Skills and Abilities:** + Knowledge of federal and state collection laws, Medicare , Medicaid,… more
    UTMB Health (07/26/25)
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  • Assistant Professor, Clinical Faculty Appointment…

    MD Anderson Cancer Center (Houston, TX)
    …Center and/or other Houston area locations for clinical service. Administrative . Must assure compliance with standards of CAP, JCAHO, FDA, Medicare , and CLIA. . ... be able to visually review, evaluate and correctly interpret medical records, patient data, patient specimens and other test...he/she is working complies with the CAP, JCAHO, FDA, Medicare , and CLIA regulations for accreditation. . Must be… more
    MD Anderson Cancer Center (07/11/25)
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  • Senior Product Owner

    CenterWell (Austin, TX)
    …delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
    CenterWell (08/23/25)
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  • Care Management Support Prof

    Humana (Austin, TX)
    …and demographic diversity. **Preferred Qualifications** + Special Needs Plan (SNP) in Medicare and/or Medicaid + Medical Social Work experience + Experience ... working with members with medical and behavioral health co-morbidities. + Experience advocating for...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
    Humana (08/29/25)
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  • RN Clinical Supervisor - Hybrid Schedule

    Aveanna Healthcare (Corpus Christi, TX)
    …care. + Collaborate with the operations and business development team. + Ensure compliance with State, Federal , Local, and Aveanna policies and procedures. ... to infants, children, adolescents, and adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related… more
    Aveanna Healthcare (08/29/25)
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  • SNF Utilization Management RN - Compact Rqd

    Humana (Austin, TX)
    …skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management ... a related field + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
    Humana (08/09/25)
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  • Complex Care Strategy Advancement Advisor

    CenterWell (Austin, TX)
    …quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity ... the Advisor will collaborate across functions (particularly Data, Technology, Analytics, Medical Economics, and Finance) to optimize strategies that address current… more
    CenterWell (07/19/25)
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