- Bristol Myers Squibb (Houston, TX)
- …with patient interest at the core of decisions should apply. The NP PA Clinical Specialist will have no direct reports and report into the Regional NPPA CS Director. ... The Dermatology Clinical Specialist will have materials created to support them in...strong understanding of Commercial payers, Medicare plans and state Medicaid in geography. + Immunology experience (emphasis on Dermatology,… more
- Prime Therapeutics (Austin, TX)
- …every decision we make. **Job Posting Title** Medication Therapy Management Specialist **Job Description** The Medication Therapy Management (MTM) Service ... Specialist is responsible for receiving inbound and making outbound...targeted population; for Medicare, is Centers for Medicare & Medicaid Services (CMS) compliance compliant + Utilize Prime's MTM… more
- Molina Healthcare (TX)
- Molina Healthcare is in search of an experienced Sr Digital Marketing Specialist . The Sr. Specialist , Digital Marketing will be responsible for analyzing and ... capable, excellent communicator, and a desire to improve processes **Preferred:** + Medicaid or Medicare Health Plan experience + Strong analytical skills **PHYSICAL… more
- Houston Methodist (Houston, TX)
- …strongly encouraged to apply.** At Houston Methodist, the System Accreditation Specialist is responsible for providing system-wide consultative services to Houston ... accreditation or health care certifications **OR** + CSHA - Certification Specialist in Healthcare Accreditation -- Related quality, accreditation or health care… more
- Molina Healthcare (Austin, TX)
- …standards and requirements established by the Centers for Medicare and Medicaid . **KNOWLEDGE/SKILLS/ABILITIES** + Enters denials and requests for appeal into ... to appeals and grievances. + Elevates appropriate appeals to the Appeals Specialist . + Generates and mails denial letters. + Assists with interdepartmental issues… more
- KPH Healthcare Services, Inc. (Longview, TX)
- **Overview** **Scope of Responsibilities:** The Intake Specialist is an experienced individual who is able to assist and manage the referral intake process. **Job ... any changes that possibly may occur within the Insurance Payor, Medicare, or Medicaid + Responsible for completing all mandatory and regulatory training programs +… more
- Aveanna Healthcare (Dallas, TX)
- Research & Resolution Specialist ApplyRefer a FriendBack Job Details Requisition #: 206745 Location: Dallas, TX 75254 Category: Medical Billing/Collections Salary: ... come into the office periodically. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant… more
- Molina Healthcare (Fort Worth, TX)
- …and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive research and resolution ... coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and knowledge of… more
- Molina Healthcare (San Antonio, TX)
- …and have a high level of customer service. Previous experience in Medicare, Medicaid , and/or Managed Care is very helpful. Top notch communication skills, both ... written and verbal are essential. Experience using Genesys and/or Sales Force software is a plus! Bilingual in Mandarin or Cantonese needed! **Job Summary** Responsible for continuous quality improvements regarding member engagement and member retention.… more
- Centene Corporation (Austin, TX)
- …fresh perspective on workplace flexibility. **Position Purpose:** The position will support the Medicaid and CHIP in the following capacity: + The role will include ... overview of the quality product performance which may include analysis of the existing performance and planning for future change in legislation/policy. The product is provided certain benchmarks by the state agency, which at times may require clinical… more