- CVS Health (Austin, TX)
- …skills to the next level? Check out this outstanding opportunity for a Medicaid Prior Authorization Pharmacist with Aetna! This is a Clinical Pharmacist Position ... supporting Medicaid Prior Authorization. An active OK, AZ or TX...retiree medical access and many other benefits depending on eligibility . For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the… 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
- Actalent (Dallas, TX)
- …or claims) + Experience in health claims processing, coordination of benefits, and eligibility + Familiarity with Medicaid and Medicare regulations + Strong ... Pay and Benefits The pay range for this position is $18.00 - $22.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and… more
- CVS Health (Austin, TX)
- …reconciliation reports received from Finance + Responds, researches, and resolves eligibility related issues involving member specific information + Applies all ... legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters. + Validates benefit plan enrollment information for… more
- ManpowerGroup (Austin, TX)
- …**Pay Range:** $20/hour **What's the Job?** + Provide unbiased assistance to Medicaid providers and clients regarding eligibility , claims status, and program ... inquiries + Respond promptly, courteously, and concisely to phone inquiries + Document all interactions clearly in online logs + Transfer callers to appropriate Call Center units as needed + Meet individual performance and attendance standards **What's… more
- Gentiva (Woodville, TX)
- …+ Understanding of palliative medicine principles, home health, hospice care eligibility , and Medicare/ Medicaid regulations. + Familiarity with the ... interdisciplinary care process. + Meets mandatory continuing education requirements for Gentiva and licensing boards. + Proficient in point-of-care software and technology. **Education/Experience:** + Master of Science in Nursing from an accredited school of… more
- Molina Healthcare (Fort Worth, TX)
- …+ Health claims processing background, including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims ... and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution… more
- CVS Health (Austin, TX)
- …actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor role. Job ... data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity. + Prepare timely and accurate Medicaid … more
- Onset Technologies LLC (Austin, TX)
- …4+ years managing multiple data projects concurrently. + 3+ years working knowledge of eligibility rules for SNAP, Medicaid , and TANF programs. + 3+ years ... experience interpreting and applying policy in integrated eligibility case management systems. What We Offer: + Competitive pay + 401K and PTO + Medical and Dental… more
- CVS Health (Pearland, TX)
- …with our Provider Engagement responsibilities as provided within the State Medicaid contractual requirements. + This role is responsible for managing distinct ... strategic Growth Partner initiatives as appropriate. + Manage and deploy the Medicaid National Provider Engagement Program through the Local Market. + Manage and… more