• Appeals & Grievances Specialist (Complaints…

    Molina Healthcare (Houston, TX)
    …a managed care organization ( Medicaid , Medicare, Marketplace and/or other government -sponsored program ), or medical office/hospital setting. * Completion of ... the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Facilitates comprehensive research and… more
    Molina Healthcare (12/14/25)
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  • Business Analyst/Product Owner

    Cayuse Holdings (Austin, TX)
    …of a team. **Preferred Qualifications:** + 4 years' experience and knowledge with Texas Medicaid programs . + 2 years' experience with the Project Enrollment and ... the Mission, Vision, and Core Values of Cayuse. **Responsibilities** + Analyzes program policies, procedures, and processes to determine the impact on business… more
    Cayuse Holdings (11/22/25)
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  • MDS Coordinator

    Southwest Nursing Center (Fort Worth, TX)
    …completion of final MDS and submits resident assessment data to the appropriate State and Federal government agencies. * Assigns, assists, and instructs staff ... data entry of resident information into appropriate computerized MDS programs . * Completes accurate coding of the MDS with...notice. Qualifications * Graduate of an approved Registered Nurse program and licensed in the state of… more
    Southwest Nursing Center (12/05/25)
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  • OCM Consultant

    Public Consulting Group (Austin, TX)
    …public better. We provide the full spectrum of technology consulting services to help state and local agencies meet operational and program needs that enhance ... * Responsible for organizational migration, gap analysis, and coordination of program improvement, communications, and training activities related to MEMS Modules,… more
    Public Consulting Group (10/04/25)
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  • Registered Manager Local Specialty

    Walgreens (Dallas, TX)
    …the billing and submission of claims to government - sponsored health care programs , including Medicare, Medicaid , and all other third-party payers, as well ... the time of refills. + Enrolls and follows patients through clinical management programs . + Oversees the enrollment of patients with assistance programs , such… more
    Walgreens (11/26/25)
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  • RN Administrator Home Health

    Elara Caring (Dallas, TX)
    …or personnel. + Oversees the implementation and oversight of all patient care programs and achievement of both clinical and administrative outcomes. + Oversees the ... to meet patient needs. + Ensures compliance of current Medicare, Medicaid , and third-party reimbursement regulations and changes. Identifies and reports potential… more
    Elara Caring (12/24/25)
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  • Chief Medical Officer, Behavioral Health

    Centene Corporation (Austin, TX)
    …all clinical functions (Utilization Management, Care Management, Quality, and Clinical Programs ). + Serve as a strategic clinical thought leader for Behavioral ... health plans for all three lines of business (Medicare, Marketplace, and Medicaid ) for delegated markets. + Focus on driving incremental reductions in… more
    Centene Corporation (11/09/25)
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  • Pre-Transplant Coordinator | Lung

    Houston Methodist (Houston, TX)
    …statistics and regulatory agencies, if applicable, such as OPTN/UNOS/CMS/NMDP/CIBMTR/FACT, and Medicaid to ensure compliance with all government reporting ... Network of Organ Sharing (OPTN/UNOS) or National Marrow Donor Programs /Foundation for Accreditation of Cellular Therapy/Center of International Blood and… more
    Houston Methodist (12/12/25)
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  • Engage Clinical Care Specialist

    Elara Caring (Dallas, TX)
    …Clinical Care Specialist is part of the ElaraConnect suite of patient engagement programs that aims to improve patient outcomes on-service. The Engage Clinical Care ... to our success in the following ways:** + Receives and maintains program referrals for assigned market (states or branch groups) identified by ElaraConnect… more
    Elara Caring (12/18/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Austin, TX)
    …under current exclusion or sanction by any state or federal health care program , including Medicare or Medicaid , and is not identified as an "excluded ... + **This position is 100% Remote and can be completed from any state . Multiple opportunities for a flexible schedule and both part-time and full-time options… more
    Evolent (12/18/25)
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