- Molina Healthcare (Houston, TX)
- **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… more
- CVS Health (Austin, TX)
- …it all with heart, each and every day. **Job Description** + The Sr. Manager , Medicare Sales Strategy develops and executes strategic initiatives to drive sales ... Medicare Advantage organizations, as well as operations, enrollment, compliance and finance + Mastery of Medicare ...enrollment, compliance and finance + Mastery of Medicare Sales and Marketing compliance guidelines and… more
- Houston Methodist (Katy, TX)
- …Access Services, and Utilization Review as needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid ... At Houston Methodist, the Manager Revenue Cycle position is responsible for the...guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and… more
- Molina Healthcare (Fort Worth, TX)
- …of the benefits, operations, communication, reporting, and data exchange of the Medicare product in support of strategic and corporate business objectives. Develops ... infrastructure, standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and… more
- Molina Healthcare (Fort Worth, TX)
- …Enrollment activities (along with other Core Ops areas of responsibilities) within Medicare and Medicaid. Role is predicated on building relationships with vendors, ... vendor performance involving onshore and offshore resources, monitors regulatory compliance adherence (in conjunction with functional counterparts) and quality… more
- Molina Healthcare (San Antonio, TX)
- …business areas and owners to ensure processes and reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with ... to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and… more
- Molina Healthcare (TX)
- …speed to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. + Ensures that adequate staffing coverage is ... leadership with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions. + Responsible for key… more
- Molina Healthcare (TX)
- …integration, and a strong understanding of data governance and compliance in healthcare environments. **Knowledge/Skills/Abilities:** * Architect and implement ... Deploy, monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and … more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Manager of Research Billing Compliance position is responsible for managing the development and execution of the Houston Methodist ... Research Institute research billing compliance program to meet all legal and institutional requirements....to those needs is well established and maintained. The manager position responsibilities include managing the daily work activities… more
- NTT America, Inc. (Plano, TX)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a ** ... Medicare Appeals Clinical Leader** to lead service delivery engagements...accordance with federal and state laws. + Identify potential compliance risks and implement corrective actions + Collaborate with… more