- Molina Healthcare (Houston, TX)
- …between Molina Healthcare and contracted provider network. In partnership with Director , manages and coordinates the Provider Services activities for the state ... outreach and resolving provider inquiries. * In conjunction with the Director , Provider Network Management & Operations, develops health plan-specific provider… more
- Humana (Austin, TX)
- …of this evolution is Humana's Insurance Segment, which provides Medicare Advantage, Medicaid , and other health plans to millions. By integrating insurance with care ... plays a pivotal role in defining the future of Humana's Medicare and Medicaid businesses, which generate the majority of the company's total revenue and earnings.… more
- Houston Methodist (Katy, TX)
- …procedures, and provides quality reviews. Reports results of key performance metrics to director on a timely basis. **FINANCE ESSENTIAL FUNCTIONS** + Assists in the ... operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash collections and… more
- Gentiva (Houston, TX)
- …treatment, consultation, and follow-up under the direction of the Palliative Medical Director (if required under State law). **As a Nurse Practitioner, you will:** ... + Work in collaboration with the Palliative Care Medical Director and other palliative team members to deliver palliative care by providing diagnosis, treatment and… 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 ... opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may require remediation...+ 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis,… more
- Humana (Austin, TX)
- …mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, by ensuring compliance with governmental requirements for ... revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and monitoring of healthcare records +… 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 ... Healthcare or Operational experience in related job. + 2 years minimum in Director level role or above. + Extensive understanding of Medicare Advantage, ACA and… more
- CenterWell (San Antonio, TX)
- …expertise with the care team through daily huddles. + Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by ... to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum of two to five years directly applicable… more
- Gentiva (Lubbock, TX)
- …Senior** to join our team. You will report directly to the Executive Director or Administrator. You will be responsible for assisting branch leadership with ... including industry standards, regulations, and best practices (ie, Medicare, Medicaid , JCAHO, ACHC), company policies/procedures, and understanding of terminally ill… more
- CVS Health (Austin, TX)
- …an exciting opportunity to join it's CVS Health's leadership team as a Director , Pharmacy Benefit Management (PBM) Underwriting, Analysis and Strategy. In this role, ... and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid , Medicare Part D, and Public Exchange lines of business. + Conduct… more