- Humana (Austin, TX)
- …expert on the End Stage Renal Disease (ESRD) population for Humana's individual Medicare Advantage plans. This includes: + Owning and improving our ESRD claims ... technical skills, especially SQL, VBA, and Databricks/Python + Individual Medicare Advantage experience + Knowledgeable on ESRD population **Additional Information**… more
- Humana (Austin, TX)
- …Principal coordinates, implements, and manages oversight of the company's Medicare /Medicaid Stars Program for aligned areas. The Stars Improvement Principal ... etc. + 5 years or more of CMS Stars program experience + Medicare Advantage experience + Previous leadership experience as a people leader, leading through… more
- Humana (Austin, TX)
- …This role will support a few tools used within our Individual Medicare Advantage pricing and internal reporting process. This includes: + Helping make ... Qualifications** + Strong technical skills, especially SQL and VBA + Individual Medicare Advantage experience Travel: While this is a remote position, occasional… more
- CenterWell (Baytown, TX)
- …role, you will be required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum of two to five years ... directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care… more
- CenterWell (Edinburg, TX)
- …service + Basic computer skills, including email and EMR **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum of two to five ... years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care… more
- CenterWell (Houston, TX)
- …Medicine or Geriatric Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five years directly applicable ... experience preferred . Experience managing Medicare Advantage panel of patients with understanding of Best...environment in a value-based relationship environment . Knowledge of Medicare guidelines and coverage . Knowledge of HEDIS quality… more
- Molina Healthcare (Houston, TX)
- …accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Manages team ... complicated claims, COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory guidelines… more
- ChenMed (Houston, TX)
- …understanding of the company's patient population, including the complexities of Medicare programs + Exceptional organizational skills with the ability to ... + An understanding of the company's patient population, including the complexities of Medicare programs + Detail-oriented with the ability to multi-task. + Able to… more
- CenterWell (Fort Worth, TX)
- …be screened for TB **Preferred Qualifications:** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum of two to five ... years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care… more
- Humana (Austin, TX)
- …Experience working in coding languages such as SAS and SQL + Prior Medicare Advantage or health insurance background + Additional skills developing reports and ... role provides a unique opportunity to get hands on Medicare Advantage experience in a rapidly growing area outside...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more