- Humana (Austin, TX)
- …Power Apps and/or Power + Proven experience working with both Medicaid and Medicare data sets + Demonstrated ability to leverage reporting solutions to address ... your life extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan, time off (including… more
- CVS Health (Austin, TX)
- …systems and the CAS and NLX applications remain in sync, supporting compliance and NCQA requirements. + Triage, submit in Greenfield, and monitor application ... reported by the prior authorization Operations teams for Pharmacy (CAS) and Medical (NLX) clients. + **Available for on-call rotating schedule** to monitor, triage… more
- Humana (Austin, TX)
- …and representing Humana IT with internal business partners along with State and Federal regulators. The Lead contributes to RFP responses to ensure they are accurate ... discuss IT priorities, new requests, and collaborate with Market Operations and Compliance teams. Facilitate and communicate with state agencies on outages, impacts,… more
- Humana (Austin, TX)
- …tax provisions under ASC 740 and SSAP 101, ensuring accuracy and compliance with US GAAP and statutory accounting principles. + Oversee tax-related disclosures ... appropriate internal controls over tax accounting and reporting, including compliance with SOX 404 requirements. + Collaborate cross-functionally with Finance,… more
- CenterWell (Beaumont, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... accordance with standards of care. . Follows level of medical care and quality for patients and monitors care..."on-call" program of CenterWell as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend… more
- CenterWell (Lubbock, TX)
- …of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team ... Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical… more
- Elara Caring (Early, TX)
- …problems to the appropriate Supervisor. + Maintains current knowledge of, and ensures compliance with all federal , state, and local regulations along with ... at no cost + Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer match + Paid time… more
- CenterWell (Houston, TX)
- …Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators ... quality of patient care using available data and chart reviews. + Complete all medical record documentation in a timely manner, working with a quality-based coder to… more
- Humana (Austin, TX)
- …financial drivers, and forecasting including headcount planning to ensure compliance with Commonwealth requirements + Performs financial impact analysis for ... that meet the short- and long-term plan objectives + Responsible for identifying medical cost trends and leadership of medical cost improvement initiatives +… more
- Humana (Austin, TX)
- …on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana. ... Experience (ME) and Medicaid Module (MED) requirements, advising stakeholders on compliance . + Works closely with operational areas to prepare documentation and… more