- Kelsey-Seybold Clinic (Sugar Land, 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
- Evolent (Austin, TX)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
- 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 (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
- Prime Therapeutics (Austin, TX)
- …Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) + Must be eligible ... Advanced degree in related area of study, such as Juris Doctor + Medicare Part D, Medicaid, and/or Affordable Care Act knowledge and experience **Physical Demands**… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of Dual contract requirements (eg, Medicare -Medicaid plans)_** + **_Experience managing external audits and communicating with ... Experience with D-SNP SMAC, regulatory requirements and/or operations required + Medicare managed health experience required Pay Range: $86,000.00 - $154,700.00 per… more
- Humana (Austin, TX)
- …+ Previous experience with pharmacy benefits management + Previous Commercial, Medicare and/or Medicaid experience + 3 or more years clinical experience ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (Fort Worth, TX)
- …State (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider ... contracting experience. * Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed… more
- Gentiva (San Angelo, TX)
- …operations, ensuring compliance with state, federal, and accreditation standards (CMS, Medicare , Joint Commission, etc.) + Provide clinical oversight and ensure ... operations leadership + Strong understanding of hospice regulations, compliance, and Medicare conditions of participation + Proven ability to manage teams, budgets,… more
- Kelsey-Seybold Clinic (Spring, 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