- Sumitomo Pharma (Austin, TX)
- …highly motivated, and experienced individual for the position of Sr. Manager, Medicaid Contract Administration. This position is responsible for managing the ... Medicaid rebate team in receiving, processing, validating, trouble-shooting ...in processing data submitted by customers and proactively advises management of issues. + Able to identify and recommend… 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, ... The Medical Director is part of a centralized team that supports the Medical Management staff and may support other health plans as needed. The Medical Director will… more
- CVS Health (Austin, TX)
- …we do it all with heart, each and every day. **Position Summary** The Medicaid Intake Business Operations team seeks an analyst with expertise in electronic claim ... This team ensures the quality and integrity of Intake processes for all Medicaid incoming claim transactions. In this position, you will provide initial support for… more
- Humana (Austin, TX)
- …the Applied Behavioral Analysis Program, and Expanded Benefits Outreach The Care Management Support Assistant Intern will utilize Humana's Medicaid training and ... first? During the period of this unpaid internship, you will work with the Medicaid Clinical Services team to ensure interaction between the company and members are… more
- Prime Therapeutics (Austin, TX)
- …and drives every decision we make. **Job Posting Title** Medication Therapy Management (MTM) Technician **Job Description** The MTM Technician is responsible for ... of business to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality measure programs,...measure programs, including but not limited to: Medication Therapy Management (MTM), Adherence, and Statin use in Persons with… more
- Humana (Austin, TX)
- …Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to ... Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as … more
- American Heart Association (Dallas, TX)
- …experience developing and leading health benefits innovation, Public Health programs, and/or Medicaid policy background.** + Strong project management skills and ... guide and oversee the Association's technical assistance work with State Medicaid 1115 Waiver Food is Medicine pilots. Responsibilities include coordinating… more
- Houston Methodist (Houston, TX)
- …from the department. This position provides technical, clerical assistance and data management support to the department staff to facilitate efficient utilization of ... resources including referrals management , communication and collaboration with providers, access to agencies... Insurance Team is responsible for obtaining and recording eligibility and benefit information for patients receiving services and… more
- Centene Corporation (San Antonio, TX)
- …healthcare outcomes. Develops strategies and objectives within long-term care management to improve member and/or provider experience. + Leads long-term ... care management and care management team on performance,...risks of complications is preferred. + Experience with Medicare, Medicaid or Marketplace insurance practices and regulations is preferred… more
- Houston Methodist (The Woodlands, TX)
- …and local coverage determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the plan of care and ... case manager, denials, and pre-bill team members, as well as management . **PEOPLE ESSENTIAL FUNCTIONS** + Establishes and maintains effective professional working… more
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