- 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
- Zelis (Plano, TX)
- …in Medicaid billing, reimbursement, claim payment or cost reporting. + Experience with Medicare / Medicare Advantage or commercial billing and reimbursement a ... plus + Ability to manage/oversee pricer program. + Subject matter expertise in prospective payment systems and advanced reimbursement methodologies . + Strong analytical and critical thinking skills-the ability to correctly decipher dense regulatory or… more
- Highmark Health (Austin, TX)
- …gain share and risk share models and will be implemented for the Organization's Medicare Advantage , Medicaid, ACA, and commercial populations with the goal of ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- Molina Healthcare (Austin, TX)
- …proficiency in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA members, the ... Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing… more
- CenterWell (San Antonio, TX)
- …+ Knowledge of HEDIS measures and quality indicators + Experience managing Medicare Advantage panel of patients with understanding of Best Practice ... in coordinated care environment in a value-based relationship environment + Fluent in Spanish and English \#nursepractitionercareers \#physicianassistantcareers \#LI-KB2 **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good… more
- Kelsey-Seybold Clinic (Shenandoah, TX)
- …to identify, understand and communicate plan details to patients with HMO, PPO, EPO, Medicare Advantage and other plans. 1+ years of cash handling or collections ... experience in a medical office setting. 2+ years of direct face to face customer service experience. **License(s)** Required: N/A Preferred: N/A **Special Skills** Required: Experience with computers and Windows-based software including Word and Excel.… 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
- Molina Healthcare (Houston, TX)
- …+ Exposure to Databricks, Spark, or similar data platforms + Familiarity with Medicare Advantage or Medicaid programs + Awareness of CMS audit processes ... or healthcare compliance requirements **Ideal Candidate Attributes** + **Curious and Eager to Learn** : Interested in understanding healthcare data and willing to dig into unfamiliar topics. + **Team-Oriented** : Works well in a collaborative environment and… more
- UTMB Health (Galveston, TX)
- …with commercial and government payers, including HMOs, PPOs, ACOs, and Medicaid/ Medicare Advantage plans. * Analyze reimbursement methodologies and contract ... performance to ensure profitability and operational effectiveness. * Develop and maintain strong relationships with payer representatives to facilitate contract negotiations and dispute resolution. * Collaborate with finance, legal, revenue cycle, and clinical… more
- CenterWell (Dallas, TX)
- …marketing; ideally field sales with a focus on senior value-based care models or Medicare Advantage . + In-depth knowledge of senior healthcare market dynamics. + ... Exceptional communication and interpersonal skills, with the ability to engage and build rapport with diverse stakeholders, including seniors, caregivers, and licensed agents. + Strong consultative selling skills, with a demonstrated ability to understand… more