- Molina Healthcare (Fort Worth, TX)
- …services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality ... leadership and quality improvement teams. * Facilitates conformance to Medicare, Medicaid , NCQA and other regulatory requirements. * Reviews quality referred issues,… more
- Molina Healthcare (Houston, TX)
- …with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and orientation of new ... line with industry standards and best practices. * Assists with new program implementation and supports for health plan in-source behavioral health services.… more
- HCA Healthcare (Dallas, TX)
- …assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, ... Qualifications** The Compliance Analyst is responsible for assisting the Compliance Manager and/or Compliance Director with analysis, tracking and resolution of… more
- Molina Healthcare (Austin, TX)
- …position is responsible for working in partnership with the Credentialing Supervisor or Manager , serving as a team lead for credentialing staff. This work may ... operating procedures and training materials. * Prepares and presents Level 2 credentialing files for Credentialing Committee meetings. * Scheduling and preparing… more
- Elevance Health (Grand Prairie, TX)
- …Resident** **Location:** This role requires associates to be in-office **1 - 2 ** days per week, fostering collaboration and connectivity, while providing flexibility ... for various operational or clinical aspects of the CarelonRx pharmacy program , including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug… more
- Elevance Health (Plano, TX)
- …family members regarding therapy plan. + Participates in the Quality Improvement program . + Ensures that all medication orders are complete, appropriate, accurate ... + Requires an MS in Nursing and minimum of 2 years of nursing experience; or any combination of...obtain credentialing with major payors in the market including Medicare/ Medicaid preferred. + Experience with IV insertion and maintenance… more