- Elevance Health (Houston, TX)
- …contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The **Audit and Reimbursement III** ... Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services).… more
- Prime Therapeutics (Austin, TX)
- …or PBM organization, or other highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must be eligible to work ... skills **Preferred Qualifications** + PBM/health care experience related to Medicare, Medicaid , Commercial, HIM + Certified Compliance and Ethics Professional (CCEP)… more
- Southwest Nursing Center (Fort Worth, TX)
- …agencies. * Assigns, assists, and instructs staff in the RAI Process, PPS Medicare, Medicaid (Case Mix as required) and clinical computer system in relation to these ... * Excellent knowledge of Case-Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required. * Thorough understanding of the Quality Indicator… more
- Molina Healthcare (Dallas, TX)
- …licensed LVN to join Molina as a Field Care Manager to work with our Medicaid members in the Dallas, TX serviced delivery area. You will complete assessments needed ... will be given to those candidates with previous experience working with the Medicaid population within a Managed Care Organization (MCO). Mileage is reimbursed as… 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
- CVS Health (Austin, TX)
- …on behalf of Elevance Health/CarelonRx across all lines of business (Commercial, Medicaid , Medicare Part D, etc.). In addition, the manager works cross-functionally ... with pharmacy contracts and contract-related documents, state and federal laws, Medicaid and Medicare Part D regulations. **Education** + Bachelor's degree in… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …for services. + Assists clients in completing application for CHIP Perinatal Program, Medicaid , Health Texas Women's Program and the Bayer Program. + Creates files ... appointments for Ob/Gyn services. + Contacts clients to follow-up on their Medicaid , CHIP Perinatal, Healthy Texas Women's and Bayer application. + Verifies… more
- Humana (Austin, TX)
- …in a medical management review organization such as Medicare Advantage, managed Medicaid , or Commercial health insurance + Current and ongoing Board Certification in ... leading to a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more
- Actalent (Austin, TX)
- …medical records (Epic, Trucare, Trucare Cloud preferred) + Knowledge of Medicaid or Medicare regulations and utilization management processes + Proficiency in ... time-management and self-motivation + Experience with EMR systems + Medicaid , Medicare or insurance-related knowledge + Prior utilization management experience… more
- R1 RCM (Austin, TX)
- …to meet their financial obligations. Work with Case Management, Clinical Staff, Medicaid Vendor, and Family Independence Agency to assist patients and families in ... Provide assistance to uninsured patients and families in completing and filing Medicaid or assistance program applications with the appropriate agency. Perform all… more