• Sr. Manager, Medicaid Contract…

    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
    Sumitomo Pharma (07/09/25)
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  • Medication Therapy Management (MTM)…

    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
    Prime Therapeutics (07/16/25)
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  • Manager, Special Investigation

    CVS Health (Austin, TX)
    …lost funds, and to comply with state regulations mandating fraud plans and reporting; Medicaid experience is preferred. Leads a team in the planning and execution of ... + A minimum 3 years of experience in a Healthcare Program Integrity, Medicaid Special Investigation or Medicaid / Medicare / Commercial Compliance role… more
    CVS Health (08/01/25)
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  • Care Coordinator - Weight Management

    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
    Houston Methodist (07/29/25)
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  • Director, Care Management - STAR Kids

    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
    Centene Corporation (08/02/25)
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  • Utilization Review Nurse - Case Management

    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
    Houston Methodist (07/12/25)
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  • Physician Assistant-Pain Management

    Baylor Scott & White Health (Killeen, TX)
    …White Health has an opening for a Physician Assistant to join our Pain Management Team in Killeen, Texas. Our facilities have national and regional recognition by US ... is billed as an independent billing provider, as recognized by Medicare and Medicaid within the healthcare systems, and in accordance with the appropriate board. The… more
    Baylor Scott & White Health (07/06/25)
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  • Specialist, Provider Data Management

    Evolent (Austin, TX)
    …Stay for the culture. **What You'll Be Doing:** The Specialist, Provider Data Management will be a dynamic role that will encompass overall support and maintenance ... : This role works closely with our Evolent partners to support data management , claims processing, and other activities that are within scope. You will work… more
    Evolent (07/31/25)
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  • Inpatient Pain Management Physician…

    Baylor Scott & White Health (Dallas, TX)
    …is billed as an independent billing provider, as recognized by Medicare and Medicaid within the healthcare systems, and in accordance with the appropriate board. The ... of care. + Counsels patients and families regarding medical processes, management of the health illness/condition, medication, nutrition, and health promotion.… more
    Baylor Scott & White Health (07/08/25)
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  • Inpatient Pain Management Acute Care Nurse…

    Baylor Scott & White Health (Dallas, TX)
    …is billed as an independent billing provider, as recognized by Medicare and Medicaid within the healthcare systems, and in accordance with the appropriate board. The ... of care. + Counsels patients and families regarding medical processes, management of the health illness/condition, medication, nutrition, and health promotion.… more
    Baylor Scott & White Health (06/19/25)
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