- Houston Methodist (Houston, TX)
- …of care and ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as management. The URSN position ... continued stay, and resource use, appropriate level of care and program compliance. Identifies when services no longer meet evidence-based criteria, initiates… more
- Molina Healthcare (Dallas, TX)
- …Experience** 1 year of experience in Medicare and in Medicaid . **Preferred License, Certification, Association** + Certified Professional in Health Quality ... with and between other departments within the organization. + Evaluates project/ program activities and results to identify opportunities for improvement. + Surfaces… more
- HCA Healthcare (Austin, TX)
- …assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, ... collections for patient services. Under the supervision of the Business Office Manager /Business Office Supervisor, you will obtain payment from third party payers… more
- Elevance Health (Grand Prairie, TX)
- …Care Pharmacy Resident** **Location:** This role requires associates to be in-office ** 1 - 2** days per week, fostering collaboration and connectivity, while ... for various operational or clinical aspects of the CarelonRx pharmacy program , including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug… more
- Humana (Austin, TX)
- …name a few: * Work-Life Balance * Generous PTO package * Health benefits effective day 1 * Annual Incentive Plan * 401K - * Well-being program * Paid Volunteer ... information to the application at Humana's secure website. + Position reports to Manager , Technology Solutions, IT HPE - Digital Channels & Contact Centers +… more
- Novo Nordisk (Houston, TX)
- …co-promotion partners. Internally, the CMCS I reports to the Portfolio District Business Manager of the specific sales territory. The CMCS I also interacts and ... of the local payer market including Medicare, Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage Requirements, Step Therapy,… more
- CenterWell (Austin, TX)
- …of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ ... Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 1 **Pay Range** The compensation range below reflects a good faith estimate of… more
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