• Senior Configuration Professional

    Humana (Austin, TX)
    …strong selling and presentation skills (oral and written) + Healthcare and Medicare experience + Experience facilitating with mixed teams, and indirect matrix teams ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (11/21/25)
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  • Associate Director, HEDIS Operations…

    Humana (Austin, TX)
    …and oversee execution of, numerous strategies required to ensure success for our Medicare Stars and Medicaid LOBs. The ideal candidate for this role will thrive ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (11/21/25)
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  • Associate Specialist, Appeals & Grievances

    Molina Healthcare (Houston, TX)
    …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials and ... * Customer/provider experience in a managed care organization (Medicaid, Medicare , Marketplace and/or other government-sponsored program), or medical office/hospital… more
    Molina Healthcare (11/21/25)
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  • Manager, Medical Economics (New York Health Plan)

    Molina Healthcare (Austin, TX)
    …performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** **Required ... - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks + Proficiency… more
    Molina Healthcare (11/21/25)
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  • Technology Solution Implementation Professional

    Humana (Austin, TX)
    …existing environment while minimizing disruption and mitigating risks + Experience with Medicare and/or Medicaid + Ability to coordinate with development and user ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (11/21/25)
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  • Consumer Strategy Advancement Lead

    Humana (Austin, TX)
    …The Consumer Segment team is an entrepreneurial, multi-functional team within Humana's Medicare and Medicaid business unit. The team is focused on driving industry ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. ​… more
    Humana (11/21/25)
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  • Liability Claims Examiner - Auto & GL

    Sedgwick (San Antonio, TX)
    …limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier; responds to requests ... principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Excellent oral… more
    Sedgwick (11/21/25)
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  • Per Diem Physician - Internal Medicine

    Kelsey-Seybold Clinic (Houston, TX)
    …and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with ... achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024.… more
    Kelsey-Seybold Clinic (11/20/25)
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  • Senior Director, Strategy & Analysis, Contract…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …contracting and in-depth understanding of GPO/PBM/National and Regional Health Plan business models, Medicare Part D, Medicare Part B, 340B, and the changing ... market landscape + In-depth knowledge of patient access, launch excellence, marketing and business processes + Strong government pricing knowledge and experience + Strong financial acumen, forecasting, and modeling abilities + Proven ability to navigate… more
    Otsuka America Pharmaceutical Inc. (11/20/25)
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  • Healthcare Staffing Specialist

    Aveanna Healthcare (Dallas, TX)
    …to work an after-hours on-call schedule. Note:As an employer receiving Medicare and Medicaid funds, employees must comply with all health-related requirements ... of Aveanna's supportive and dynamic environment. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements… more
    Aveanna Healthcare (11/19/25)
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