- Humana (Austin, TX)
- …& Clinical Innovation + Corporate Strategy & Transformation Office + Medicare & Medicaid Market Operations + Provider Relations & Network Performance + Marketing & ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Humana (Austin, TX)
- …residence + Eligibility to participate in federal prescription programs (eg, Medicare/ Medicaid ) + Self-directed with the ability to work effectively both ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Elevance Health (Grand Prairie, TX)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement Senior** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
- BrightSpring Health Services (Lubbock, TX)
- …issues of denials or follow-up of claims. + Maintains current knowledge of Medicaid claim regulations and processes. + Produces reports and keeps management informed ... Desired: Prior supervisory experience. Skills/Knowledge: + Required: Knowledge of Medicaid claims regulations and processes. Basic understanding of drugs, medication… more
- Humana (Austin, TX)
- …Guidance on following and reviewing home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Molina Healthcare (El Paso, TX)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis, and/or interpretation +… more
- CVS Health (Austin, TX)
- …within Network; Examples include ensuring data standards are synchronized across Medicaid and Medicare platforms, ensuring duals workflows are support across ... experience in strategy and delivery leadership roles + 5+ years of Medicare/ Medicaid and/or Duals experience + Proven success navigating large scale cross functional… more
- Humana (Austin, TX)
- …revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of healthcare records + ... are leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Molina Healthcare (Fort Worth, TX)
- …evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This role has decision-making accountability for ensuring ... or above. + Extensive understanding of Medicare Advantage, ACA and Medicaid risk adjustment processes, including encounter data submission and deletion requirements… more
- Molina Healthcare (Houston, TX)
- …or equivalent combination of relevant education and experience + Medicare and/or Medicaid Managed Care experience + Quantitative aptitude + Strong leadership in a ... experts, and external resources. **PREFERRED QUALIFICATIONS:** + Integrated products ( Medicaid -Medicare) experience + Experience in regulatory regulations and monitoring… more