- Humana (Austin, TX)
- …financial results, and many ad hoc analyses related to the business (risk, compliance , operations, etc.) They will advise market leadership and executives to develop ... peer-reviewed results **Preferred Qualifications** + 5 years of experience within the managed Medicaid industry + 3 years of project management experience + In… more
- Elara Caring (Mount Vernon, TX)
- …absences + Ensures all clients w/o an attendant (CWA), holds and updates are managed per Elara Caring protocol; ensuring all regulatory documentation has been ... our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right...2067 (client communication form) as required + Completes all Compliance items in Arrow for Tracking the new hire… more
- ChenMed (Houston, TX)
- …members. This position adheres to strict departmental goals/objectives, standards of performance, regulatory compliance , quality patient care compliance and ... Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired + This position requires...90 days of employment We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare … more
- Grifols Shared Services North America, Inc (Fort Worth, TX)
- …work performance and deliverables meet or exceed goals and objectives. + Ensures compliance with all applicable regulatory , legal, and operational rules and ... an international team working to improve the future of healthcare ? Do you want to enhance the lives of...to appropriate groups such as the following: key accounts, managed care organizations, integrated systems, national medical associations, and… more
- UTMB Health (Huntsville, TX)
- …States** Allied Health UTMB Health Requisition # 2504644 The mission of Correctional Managed Care is to address the healthcare needs of underserved patient ... of medications, equipment, devices, and other supplies + Supports pharmacy compliance with professional standards and relevant legal, regulatory , formulary,… more
- Prime Therapeutics (Austin, TX)
- …communication, negotiation, and relationship management abilities + Knowledge of healthcare regulations, payer strategies, and compliance requirements + ... experience within medical and pharmacy drug management within a PBM or managed care organization, or oncology management experience if supporting oncology specialty… more
- Veolia North America (Beaumont, TX)
- …energy consulting and resource recovery. Veolia helps commercial, industrial, healthcare , higher education and municipality customers throughout North America. ... and in accordance with site capabilities, approved permits, and appropriate regulatory requirements. Determine acceptability or rejection of chemical components of… more
- Prime Therapeutics (Austin, TX)
- …on fraud, waste and abuse issues and maintains confidentiality and compliance with HIPAA privacyrequirements and applicable state and federal regulations. ... + Prioritize and manage workload to meet internal performance metrics, regulatory and contractual requirements. + Analyze data to find suspicious patterns… more
- Banner Health (TX)
- …areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office ... to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of… more
- CVS Health (Austin, TX)
- …Set (HEDIS(R)) improvement work + Interacts with providers and/or members to improve healthcare outcomes such as increased preventive care compliance + Supports ... and Aetna + Provides support for HEDIS(R) quality initiatives and regulatory /contractual requirements including outreach to members who are noncompliant in the… more