- CenterWell (Austin, TX)
- …delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers associates to ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- Molina Healthcare (El Paso, TX)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with… more
- Aveanna Healthcare (Corpus Christi, TX)
- …Position Details Position: Clinical Supervisor (RN) $5,000 SIGN ON BONUS Clinical Case Manager Join a Company That Puts People First! Aveanna Healthcare is one of ... + Collaborate with the operations and business development team. + Ensure compliance with State, Federal, Local, and Aveanna policies and procedures. Qualifications… more
- CenterWell (Austin, TX)
- …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- CenterWell (Austin, TX)
- …quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity ... quality and value drivers in full risk care delivery, ideally in Medicare /seniors + Demonstrated ability to work collaboratively with clinical and operational… more
- CenterWell (Corpus Christi, TX)
- …two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... care environment in a value-based relationship environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Additional… more
- Fresenius Medical Center (Fort Worth, TX)
- …nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal ... ongoing performance of other PCT's. + Collaborates with the Clinical Manager and Education Coordinator in driving organization quality standards through education… more
- HCA Healthcare (San Antonio, TX)
- …physician approved orders and clinician plotted visits approved by Clinical Services Manager . Ensures compliance with the schedule. Communicates any requests to ... requirements. Tracks and provides feedback to the Clinical Services Manager when scheduled visits are missed. **What you will...quality care during their recovery at home. We are Medicare certified. Our patients are under the supervision of… more
- Highmark Health (Austin, TX)
- …with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts ... system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare… more
- Houston Methodist (Houston, TX)
- …to research patients under the supervision of the Clinical Trials Manager and Principal Investigator. This position implements clinical research patient care ... and provide guidance on the administration of the GCP compliance , financial and other related aspects of the research...process for new staff in conjunction with Clinical Trials Manager . Precepts new clinical research staff in clinical setting.… more