- CVS Health (Austin, TX)
- …every day. **Position Summary** This role will report to the Executive Director of Medicaid Business Development. This role is central to advancing our Medicaid ... and executing state-specific strategies that align with healthcare policy and individual Medicaid priorities. The ideal candidate will bring deep expertise in … 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
- Centene Corporation (Austin, TX)
- …workplace flexibility. **Centene is Hiring a Remote Psychologist - Join Our Oklahoma Medicaid Team!** Are you a licensed Psychologist with a passion for improving ... is seeking a **Remote Psychologist** to support our **Oklahoma Medicaid plan** . In this role, you'll play a...forms of incentives. Benefits may be subject to program eligibility . Centene is an equal opportunity employer that is… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of Dual contract requirements (eg, Medicare- Medicaid plans)_** + **_Experience managing external audits and communicating with ... + Manage approval and submission of timely and accurate D-SNP State Medicaid Agency ("SMAC") contract and regulatory required report deliverables not limited to… more
- CVS Health (Austin, TX)
- …support segment leaders with growing focus on our Specialty Medicare Advantage and Medicaid VBC portfolio. **You will make an impact by:** . Supporting the process ... for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners. . Developing relationships with leaders of specialty chronic… more
- CVS Health (Austin, TX)
- …multiple health plan clients across multiple lines of business including Medicare, Medicaid , Exchange, and Commercial. This is a remote role, open to qualified ... understanding of CVSH clinical portfolio, marketplace segments dynamics (Medicare, Medicaid , Exchange, and or Commercial) and industry trends + Demonstrated… more
- Cognizant (Austin, TX)
- …features. * Drive improvements in digital quoting, application intake, eligibility verification, and member onboarding for individual, group, and ... government-sponsored health plans (Medicare, Medicaid , ACA), ensuring compliance with CMS, ACA, and other regulatory requirements. **Work Model:** We strive to… more
- CVS Health (Austin, TX)
- …to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with community resources and ... **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with individuals with SDoH needs,… more
- TEKsystems (Dallas, TX)
- …enrollment and re-enrollment applications for healthcare providers to Medicare, Medicaid , and commercial insurance plans. Maintain accurate and up-to-date provider ... enrollment, credentialing, or healthcare administration. Strong understanding of Medicare, Medicaid , and commercial insurance enrollment processes. Excellent organizational, communication,… more