- CenterWell (Beaumont, TX)
- …of two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... Medicine preferred + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum...in a value based relationship environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality… more
- CenterWell (Corpus Christi, TX)
- …of two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... care environment in a value-based relationship environment + Knowledge of Medicare guidelines and coverage + Knowledge of HEDIS quality indicators **Additional… more
- Highmark Health (Austin, TX)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- CenterWell (Houston, TX)
- …with dobutamine pump + Work experience in electrophysiology + Experience managing Medicare Advantage panel of patients with understanding of Best Practice ... care environment in a value based relationship environment preferred. + Knowledge of Medicare guidelines and coverage + Bilingual is a plus + Knowledge of HEDIS… more
- CenterWell (Austin, TX)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage / Medicare /Medicaid Experience a plus + Current nursing ... experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life… more
- Humana (Austin, TX)
- …+ **Industry Knowledge** : Familiarity with the healthcare sector, specifically Medicare Advantage , and an understanding of regulatory frameworks and ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- ChenMed (Houston, TX)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... be America's leading primary care provider, transforming care of the neediest population. Our mission is to honor seniors with affordable VIP care that delivers better health. In order to achieve our vision and deliver our mission, we need the best primary… more
- ChenMed (Houston, TX)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... be America's leading primary care provider, transforming care of the neediest population. Our mission is to honor seniors with affordable VIP care that delivers better health. In order to achieve our vision and deliver our mission, we need the best primary… more
- Datavant (Austin, TX)
- …teams to improve productivity and quality.** + Run various risk adjustment models for Medicare Advantage , Medicaid or ACA to forecast patient risk scores and ... return on investment based on historical data and project variables + Work closely with cross-functional teams, including clients, to understand business needs, and determine the right methodology for analysis and assumptions to provide data-driven insights… more
- Health Care Service Corporation (Richardson, TX)
- …Job Qualifications:** + MBA or MHA. + Health care industry experience. + Medicare Advantage knowledge and expertise. + Commercial, Affordable Care Act knowledge ... and/or Medicaid MCO. + Knowledge a plus. **This is a Flex (Hybrid) role: 3 days in office; 2 days remote.** **Sponsorship is not available.** \#LI-LO1 \#LI-Hybrid **Are you being referred to one of our roles? If so, ask your connection at HCSC about our… more