- Highmark Health (Austin, TX)
- …goals including but not limited to Government Markets (STARS, ACA, CHIP, Medicaid DE) and Enterprise Quality, Safety, and Values (Health Outcomes Measures). Provide ... share models and will be implemented for the Organization's Medicare Advantage, Medicaid , ACA, and commercial populations with the goal of maximizing quality while… more
- Robert Half Finance & Accounting (Dallas, TX)
- …Collaborate with skilled nursing facility staff to verify resident levels. + Confirm Medicaid room and board rates while ensuring accurate billing system updates. + ... Verify nursing facility and hospital payments ( Medicaid room and board) and resolve discrepancies. + Work...2 + years of hospice billing billing required (Medicare, Medicaid , Insurance, Private Pay). + Proficiency with billing systems… more
- Molina Healthcare (Houston, TX)
- …complaints. Works with enrollees and providers to facilitate the provision of Medicaid benefits and ensure enrollee's rights are upheld. Helps enrollees understand ... and members regarding community agencies, services and referrals for special needs, Medicaid in general, or other related needs. * Participates in the Statewide… more
- Prime Therapeutics (Austin, TX)
- …pharmaceutical manufacturers, with specific emphasis on Medicare Part D and Managed Medicaid . The Sr Director, Pharm Trade Relations leads a team of directors ... Trade formulary strategies for Commercial, Exchange, Medicare Part D and/or Medicaid template formularies, including items such as manufacturer and GPO negotiation,… more
- Humana (Austin, TX)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ ... in a medical management review organization, such as Medicare Advantage, managed Medicaid , or Commercial health insurance. + Experience with national guidelines such… more
- Prime Therapeutics (Austin, TX)
- …client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned **Education & Experience** + Bachelor's ... within a highly regulated industry, including experience with Medicare, Medicaid , and the Affordable Care Act (ACA) + Must...study, such as Juris Doctor + Medicare Part D, Medicaid , and/or Affordable Care Act knowledge and experience **Physical… more
- Baylor Scott & White Health (Dallas, TX)
- …standards, such as the Joint Commission, Centers for Medicare and Medicaid (CMS), National Committee for Quality Assurance (NCQA), Health Insurance Portability ... Commission (HHSC), Office of Inspector General (OIG), the Centers for Medicare and Medicaid Services (CMS), and the Texas Department of Insurance (TDI). - Manages… more
- Baylor Scott & White Health (Austin, TX)
- …to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends ... . Responds to inquiries and guidance requests utilizing applicable Medicare and Medicaid rules and regulations. Serves as a compliance resource to BSWH departments… more
- Aveanna Healthcare (San Antonio, TX)
- …an after-hours on-call schedule. Note:As an employer receiving Medicare and Medicaid funds, employees must comply with all health-related requirements in relevant ... Aveanna's supportive and dynamic environment. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …billing compliance requirements. Regularly reviews JH-MAC website and Texas Medicaid policies. Demonstrate knowledge of compliance documentation and coding ... background check, as well as not be listed on the HHS OIG, Texas Medicaid , GSA or any other government exclusion lists. **Campus:** HSC - El Paso **Department:**… more