• AVP, Medicare Duals Optimization (Remote)

    Molina Healthcare (Austin, TX)
    …and in compliance with all relevant federal, state, and local regulatory requirements. **Job Duties** + Supports strategy development, vision and direction for ... + Coordinates accountabilities between duals office and shared service to drive compliance and efficiency as well as provide oversight, including service level… more
    Molina Healthcare (09/07/25)
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  • Supervisor, Care Management

    Molina Healthcare (Fort Worth, TX)
    **JOB DESCRIPTION** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and ... management, and/or transition of care activities to assist Molina Healthcare members with their healthcare needs. Care...align with the model of care and that meet regulatory requirements. + Manages staff caseloads and assigns cases… more
    Molina Healthcare (08/27/25)
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  • Deputy General Counsel, Litigation - REMOTE

    Prime Therapeutics (Austin, TX)
    …(corporate governance, dispute resolution, contract negotiation, employment law, audits/investigations, regulatory compliance ) + 3 years of experience advising ... visa or residency sponsorship **Additional Qualifications** + Advanced knowledge of PBM regulatory frameworks and healthcare law, with demonstrated ability to… more
    Prime Therapeutics (07/19/25)
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  • System Manager Revenue Cycle (Medicare Hospital…

    Houston Methodist (Katy, TX)
    compliance with ethical and legal business practices and accreditation/ regulatory / government regulations. **Ideal candidates will have the following:** + ... Access Services, and Utilization Review as needed to ensure operational billing compliance with government/ regulatory agencies and the Medicare and Medicaid… more
    Houston Methodist (08/13/25)
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  • Chief Financial Officer, UT Health RGV

    University of Texas Rio Grande Valley (Edinburg, TX)
    …budgeting, financial reporting, oversight of managed care contracts, and to ensure compliance with regulatory standards. The CFO plays a critical role in ... driving financial performance, sustainability, and operational efficiency across the healthcare enterprise. Description of Duties * Leads all aspects of financial… more
    University of Texas Rio Grande Valley (08/09/25)
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  • Medical Director - Mid West Region

    Humana (Austin, TX)
    …site of service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include ... medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements,… more
    Humana (08/08/25)
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  • Senior Contract Administrator - Revenue Cycle Ops…

    UTMB Health (Galveston, TX)
    …Strong knowledge of healthcare reimbursement models, contract terms, and regulatory compliance . * Knowledgeable of professional and hospital physician ... clinical operations to ensure contract terms align with organizational capabilities and compliance standards. * Monitor regulatory and market changes affecting… more
    UTMB Health (08/08/25)
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  • Case Manager Certified - Transition in Care

    Houston Methodist (Cypress, TX)
    …service line. This position works with the physicians and interprofessional healthcare team to facilitate and maintain compassionate, efficient quality care and ... + Collaborates with the physician and all members of the interprofessional healthcare team to facilitate care for designated assignment; monitors the patient's… more
    Houston Methodist (08/27/25)
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  • Head of Observability and Monitoring

    Truist (Dallas, TX)
    …** Compliance and Regulatory Knowledge:** In-depth understanding of compliance in regulated industries (eg, financial services, healthcare ). Experience ... Planning & Governance:** Define and implement observability governance frameworks, ensuring compliance with regulatory requirements (eg, FFIEC, OCC, Basel III,… more
    Truist (07/03/25)
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  • Medical Director - Acute Rehab Team

    Humana (Austin, TX)
    …site of service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include ... thinking and authorship. Exercises independence in meeting enterprise expectations and compliance timelines. This is a full-time work from home opportunity.… more
    Humana (09/05/25)
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