- Humana (Austin, TX)
- …meet required timelines. + Submits required documents to state agencies for review and approval. + Regularly meet with Humana Healthy Horizons Medicaid markets ... and/or Medicaid health plan operations, such as provider relations, claims submission and payment, utilization management processes, behavioral health processes,… more
- CVS Health (Austin, TX)
- …ad hoc report development to identify fraud, waste, and abuse schemes and trends. - Review company clinical and payment policies to determine the impact of the scheme ... -3-5 years of data interpretation and analysis experience. -Experience with internal claims data and healthcare coding. -Must be able to travel to provide… more
- Dow (Houston, TX)
- …land ownership, liens and prior encumbrances. + Negotiate and settle damage claims with landowners and tenants resulting from Dow pipeline construction, operations ... reimbursement agreements following GCPL's prescribed procedure for qualifying projects. + Review and approve Letters of No Objection for third party encroachments.… more
- WTW (Dallas, TX)
- …health and benefits projects supporting the design and management of group medical , dental, wellbeing, life, disability and absence management benefits for clients. ... to day to day service issues and questions (eligibility, carrier coverage and claims issues, compliance, etc.) + Preparation for client meetings (prepare agendas and… more
- CVS Health (Austin, TX)
- …frontline advocates for members who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current case management ... to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and… more
- Elevance Health (Grand Prairie, TX)
- …of the care management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of care management treatment ... of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of utilization/care management… more
- Elevance Health (Houston, TX)
- …of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment ... of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of utilization/care management… more
- Sumitomo Pharma (Austin, TX)
- …regulatory submissions by preparing responses to agency inquiries and contributing to labeling claims . + Review Case Report Forms (CRFs) to ensure data ... teams-including clinical development, clinical operations, data management, programming, and medical writing-to maintain the statistical integrity of study conduct.… more
- Texas Health Resources (Fort Worth, TX)
- …an acute health care setting. + Ongoing and in-service training, annual review and competency validation, and event-specific training. + Promote patient satisfaction ... respond to patient and family complaints. + Demonstrate ability toreduce liability claims , sentinel events, near misses, and the overall cost of the organization's… more
- Robert Half The Creative Group (Irving, TX)
- …creative guidelines with error-free punctuation and grammar. The Copy Editor will also review all the creative copy, content, drafts, and proofs for consistency with ... social, OOH, etc.), ensuring consistency, grammar, brand voice, and clarity. Fact-check claims and verify proper formatting for style guides (AP, Chicago, or… more