- CVS Health (Austin, TX)
- …do it all with heart, each and every day. **Position Summary** **The Medicaid Senior Manager , Network Management:** * Negotiates, executes, conducts high level ... Office suite applications (eg, Outlook, Word, Excel, etc.). - Knowledge of Medicaid programs. * Solid decision-making skills while executing national, regional, and… more
- Humana (Austin, TX)
- …support across a broad range of actuarial, managerial, and business needs for Medicaid -specific product lines. The Lead Actuary will serve as a project manager ... review and documentation. The Lead Actuary will be responsible for Medicaid -specific functions such as capitation rate review, drafting rate advocacy communications,… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina...- 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans +… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Manager , Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. ... The Manager , Fraud and Waste works within specific guidelines and...experiences **Preferred Qualifications** + Proven knowledge in Medicare and Medicaid regulations + Certifications (BA, MBA, JD, MSN, Clinical… more
- CenterWell (Austin, TX)
- …a part of our caring community and help us put health first** The Medicaid Drug Strategy Pharmacist Lead requires a broad understanding of pharmacy, managed care, ... drug strategies to mitigate cost trend and improve health outcomes. The Medicaid Drug Strategy Pharmacist Lead work assignments involve moderately complex to complex… more
- Elevance Health (Grand Prairie, TX)
- **Business Information Analyst Senior - Medicaid Encounters Data** The **Business Information Analyst Senior** is responsible for analyzing and validating healthcare ... encounter data submissions to CMS (Centers for Medicare & Medicaid Services). This role involves ensuring the accuracy and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- CVS Health (Austin, TX)
- …experience + Knowledge of the regulations, standards, and policies which relate to Medicaid Care Management + Certified Case Manager (CCM) **Education** + **If ... heart, each and every day. **Position Summary** The Senior Manager Clinical Health Services is a key member of...organization and development of high performing teams. The Senior Manager is also responsible for ensuring the functioning of… more
- Molina Healthcare (TX)
- …monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and compliance ... in deploying and monitoring big data infrastructure with Ambari, Cloudera Manager , and Zookeeper. * Solid understanding of data warehousing, data validation,… more
- Molina Healthcare (Roma, TX)
- …LVN or Licensed Behavioral Health professional in Texas to join Molina as a Case Manager working with our Medicaid members in the service delivery area of Zapata ... **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Active and unrestricted Certified Case Manager (CCM) Active, unrestricted State Nursing license (LVN/LPN) OR… more
- Prime Therapeutics (Austin, TX)
- …passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative ... teamwork across all internal departments, as well as with Medicaid Clients, and an in-depth understanding of all rebate...state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each… more