- Humana (Austin, TX)
- …clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis and interpretation ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Houston Methodist (Katy, TX)
- …to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash ... Outpatient Prospective Payment Systems, etc. + Stays informed of the latest Medicare , Medicaid and commercial payor news, updates, and regulations and adjusts… more
- Highmark Health (Austin, TX)
- …experience in managed care pharmacy + 2 years of clinical account management experience in Medicare as part of the 4 year managed care experience + 2 years of ... experience analyzing pharmaceutical cost of care data **Substitutions** + None **Preferred** + Masters of Pharmacy or Masters of Business Administration + AMCP-ASHP accredited residency in managed care pharmacy + Experience leading or participating in Pharmacy… more
- Guidehouse (Lewisville, TX)
- …from home._** **Essential Job Functions** + Account Review + Appeals & Denials + Medicare /Medicaid + Insurance Follow-up + Customer Service + Billing + UB-04 & CMS ... 1500 + Complete all business-related requests and correspondence from patients and insurance companies. + Responsible for working on 40-70 Accounts Per Day + Complete all assigned projects in a timely manner. + Assist client and patients in all requested… more
- Amazon (TX)
- …Application deadline: Jan 8, 2026 As a Program Manager II on the One Medical At -Risk team, you will be the primary builder of new and existing capabilities and ... programs aimed at improving health outcomes for our at-risk patient populations. Working within Amazon's mission to be Earth's most customer-centric company, you will drive operational improvement and strategic initiatives from concept to implementation,… more
- UTMB Health (Galveston, TX)
- …calculations and estimates and ensures UTMB compliance with Medicare and Medicaid regulations. **Scope:** Institutional **Responsibilities:** + Responsible ... for technical aspects, calculations and analyses of multiple areas of Medicare and Medicaid reimbursement components including, but not limited to, cost report… more
- Humana (Austin, TX)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Abbott (Austin, TX)
- …for implementing and managing clinical trial reimbursement processes to secure Medicare and private payer reimbursement for designated clinical trials. This position ... **What You'll Work On** + Review clinical investigative plan and payer policies ( Medicare , Medicare Advantage, Medicaid and Private Payer) to provide coverage… more
- Humana (Austin, TX)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Health Care Service Corporation (Richardson, TX)
- …the team to support divisional short and long-term initiatives related to Medicare provider network strategy and leverage analytics to drive provider network ... strategic network initiatives from inception to completion. This position will analyze Medicare network data using internal and external sources to support the… more