- Houston Methodist (Houston, TX)
- …compliance with ethical and legal business practices and accreditation/ regulatory /government regulations. **PEOPLE ESSENTIAL FUNCTIONS** + Directs, develops and ... At Houston Methodist, the Director Managed Care Contracting position is responsible for the...for employee engagement, adequate staffing levels, budget development and compliance , staffing decisions such as hiring and terminating employment,… more
- NTT DATA North America (Houston, TX)
- …services, and industry vertical solutions to include things like regulatory compliance solutions, digital solutions, mobile solutions, transformational ... apply now. We are currently seeking a IT Sales Managed Services/Professional Services/Life Sciences (Remote) to join our team...acquire net new logos + A passion for improving healthcare and patient outcomes and recognized as an expert… more
- Humana (Austin, TX)
- …be required to work in either Central or Eastern Time. Associate Director, Regulatory Intake Compliance is responsible for enterprise-wide regulatory ... risk exposure for the organization. The Associate Director, Regulatory Intake Compliance will be responsible for/to:...years of management experience + Advanced experience working in compliance , risk management, or managed -care field +… more
- Molina Healthcare (San Antonio, TX)
- …review. The position may also work with other internal departments, including Compliance , Corporate Legal Counsel, and Medical Officers in order to achieve and ... various internal customers (eg, Provider Services, Contracting and Credentialing, Healthcare Services, Member Services, Claims) to gather documentation pertinent to… more
- Highmark Health (Austin, TX)
- …healthcare operations, risk, audit, or legal functions + 5 years in Healthcare Compliance or Privacy **LICENSES or CERTIFICATIONS** **Required** + None ... rules as well as a solid working knowledge of managed care operations, compliance program structures, information...(CIA) + Certified Fraud Examiner (CFE) + Certified in Healthcare Compliance (CHC) + Certified Compliance… more
- Molina Healthcare (Fort Worth, TX)
- …Degree in Healthcare Administration **Preferred Experience** + 10 years of managed care experience ( Regulatory and Compliance ) + Previous management ... Administration such as oversight, audit, etc. **Required Experience** * 7 years of managed care experience ( Regulatory and Compliance ) * Previous management… more
- Molina Healthcare (TX)
- …network development and management, or project management experience in a managed healthcare setting. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : ... in a managed care setting. * Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare… more
- Molina Healthcare (Austin, TX)
- …Participate in process improvement initiatives to improve operations + Understands the compliance and regulatory guidelines for each state + Maintains ... coaching, production and appropriate terminations. + Ensures staff is compliant with regulatory and company guidelines, including HIPAA compliance . + Responsible… more
- Molina Healthcare (Houston, TX)
- …ancillary providers with Medicaid and/or Medicare products * 5+ years previous managed healthcare experience. * Previous experience with community agencies and ... providers. * Experience demonstrating working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicare or… more
- Molina Healthcare (TX)
- …dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care + Track regulatory compliance and address any operational ... and experience + 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related… more