- Molina Healthcare (Houston, TX)
- …resolution of investigations. **Knowledge/Skills/Abilities** * Responsible for oversight and management of Health Plan Compliance Directors for all ... compliance with applicable statutes and policies. * Provides leadership to Health Plan Compliance Directors on training and education of compliance … more
- ManpowerGroup (Houston, TX)
- …in accordance with the Compliance Program, and with HHSC, TDI, NCQA and Health Plan Senior Management. * Ensure ongoing compliance with federal and ... internal and external auditing and real-time monitoring activities related to the Health Plan 's regulatory and contractual requirements in accordance with the… more
- Centene Corporation (Austin, TX)
- …fraud and abuse and anti-kickback statutes, OIG and government health plan guidelines and state marketing compliance laws, prompt pay, provider adequacy ... one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national… more
- Baylor Scott & White Health (Temple, TX)
- …the BSW Medical Group and both the Quality Alliance and BSW Health Plan . + Ensure regulatory and licensure compliance across all geographies + Advise on ... to help redefine how care is delivered across Texas? Baylor Scott & White Health is launching a transformative **Virtual Primary Care (VPC)** program - and we're… more
- Apex Health Solutions (Houston, TX)
- …Quality Management, Pharmacy, Provider relations and other health plan departments Adheres to all Compliance /Program Integrity requirements. Complies ... Conducts chronic disease and self-management education and support to improve comprehension, health literacy and adherence to established plan of care. Provides… more
- CVS Health (Austin, TX)
- …management including results reporting and issue follow-up. **Responsibilities/Estimated % of Time** ** Compliance Monitoring Plan Execution** (80%) + Plan ... as compliance monitoring testing for assigned monitoring plan activities. This may include concurrent and/or complex business...compliance performance for a wide range of CVS Health business units. ** Compliance COE Team Support**… more
- Baylor Scott & White Health (Temple, TX)
- …on position type and/or level **Job Summary** The Vice President Pharmacy Health Plan (HP) oversees planning, directing, and coordinating pharmacy operations ... packaging, and dispensing of drugs and therapeutics for BSWH Health Plan pharmacy. Plans and directs pharmacy...will reshape the care delivery system and improve members' health . + Ensures compliance with all applicable… more
- Cardinal Health (Austin, TX)
- …audit and monitoring plan . The Manager has supervisory responsibility for all Compliance Audit staff. **_What is expected of you and others at this level_** + ... **_What Ethics & Compliance contributes to Cardinal Health_** Ethics & ...Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) +… more
- Cardinal Health (Austin, TX)
- …KRIs as well as reporting processes to provide ongoing updates to leadership on health of the IT compliance program effectiveness, risk exposure, and ... well as completes risk assessments. The IT Governance and Compliance function within the organization develops, enhances, and maintains...Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) +… more
- Highmark Health (Austin, TX)
- …incumbent is responsible for the collaborative and iterative development of the risk and compliance plan for these entities across all areas in the enterprise ... This job is responsible for planning, designing, implementing, and maintaining the Compliance Program and its related policies to ensure the business acts within… more