• Clinical Appeals Nurse (RN)

    Molina Healthcare (San Antonio, TX)
    …appropriate and correct clinical decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) ... Guidelines, MCG, InterQual or other medically appropriate clinical guidelines, Medicaid , Medicare, CHIP and Marketplace, applicable State regulatory requirements,… more
    Molina Healthcare (08/15/25)
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  • Senior Clinical Programs Pharmacist

    CenterWell (Austin, TX)
    …Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years clinical experience in managed ... 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 (08/08/25)
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  • Community Health Worker (CHW)

    CenterWell (Port Arthur, TX)
    …100,000/300,000/100,000 limits. **Preferred Qualifications** **Prior experience with Medicare & Medicaid recipients** + Previous experience with electronic case note ... 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 (07/09/25)
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