- Molina Healthcare (Fort Worth, TX)
- …Summary** Responsible for successful oversite and implementation of the Texas Medicaid Directed Payment Program (DPP) and internal business projects and programs ... Benefit Configuration processes. + Experience with Managed Care + Experience with TX Medicaid /CHIP and TX Directed Payment Programs (DPP). + Experience with QNXT and… more
- Molina Healthcare (San Antonio, TX)
- …and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution ... coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of… more
- Humana (Austin, TX)
- …experiences **Preferred Qualifications** + Proven knowledge in Medicare and Medicaid regulations + Certifications (BA, MBA, JD, MSN, Clinical Certifications, ... 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)
- …Checkout this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid managed care plans in multiple states: Arizona, Florida, Illinois, Kentucky, ... Review experience -Electronic medical systems/record experience -Managed Care experience - Medicaid experience **Education:** -M.D. or DO, Board Certification in ABMS… more
- Molina Healthcare (Austin, TX)
- …and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** ... + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks… more
- CVS Health (Austin, TX)
- …it all with heart, each and every day. **Position Summary** **The Medicaid Senior Manager, Network Management:** * Negotiates, executes, conducts high level review ... Office suite applications (eg, Outlook, Word, Excel, etc.). - Knowledge of Medicaid programs. * Solid decision-making skills while executing national, regional, and… more
- Molina Healthcare (TX)
- …**Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, ... available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze risk score… more
- Molina Healthcare (Fort Worth, TX)
- …+ 5-7 years of product development experience. + Managed Care (specifically Medicaid ) experience. + Experience working in a cross functional highly matrixed ... organization. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal… more
- Prime Therapeutics (Austin, TX)
- …every decision we make. **Job Posting Title** Senior Business Analyst - Medicaid Implementations - Remote **Job Description** The Business Analyst (BA) Senior will ... execute on medium projects as a liaison among business operations, technology groups, clients, business partners, vendors, and project/program team to understand, analyze, and facilitate business needs, requirements, and impacts of business changes as a result… more
- CVS Health (Austin, TX)
- …initiatives to support audit readiness and collaborates with Compliance, Legal, Medicaid Health Plans, Network Contracting, and Provider Relations to ensure ... alignment with regulatory and contractual obligations. The Lead Director will also serve as a key liaison between Compliance, Legal, Network Contracting, and Provider Relations teams. **Required Qualifications** + A minimum of 7 years of healthcare payer… more