- NASCO (Austin, TX)
- …laws and regulations related to our products and services, including for our Medicare Advantage and ACA Exchanges business + Interacts with vendors and ... to identify and mitigate legal and business risks and provide practical solutions to complex issues to support our...compliance issues, including related to HIPAA + Experience supporting Medicare Advantage and ACA Exchanges business **Required… 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 ... Risk Adjustment submissions data to evaluate healthcare intervention program performance . Develops and presents Risk Adjustment intervention ROI, incremental… more
- UTMB Health (Galveston, TX)
- …with commercial and government payers, including HMOs, PPOs, ACOs, and Medicaid/ Medicare Advantage plans. * Analyze reimbursement methodologies and contract ... This role will oversee payer relationships, evaluate financial and operational performance of contracts, and collaborate across departments to support strategic… 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. + ... and a proven track record of successful field sales / grassroots marketing performance . This position presents an exciting opportunity to make a meaningful impact in… 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...goals, and when leading their care teams towards their performance goals. We are an outcomes-focused, value-based organization and… more
- CenterWell (Corpus Christi, TX)
- …* Knowledge of HEDIS measures and quality indicators * Experience managing Medicare Advantage panel of patients with understanding of Best Practice ... plan. This incentive opportunity is based upon company and/or individual performance . **Description of Benefits** Humana, Inc. and its affiliated subsidiaries… more
- Sedgwick (Plano, TX)
- …of experts to both learn from and to share your insights. + Take advantage of a variety of professional development opportunities that help you perform your best ... identify subrogation of claims and negotiate settlements; and to provide backup for team lead when out of the...Second Injury Fund excess recoveries and Social Security and Medicare offsets. + Reports claims to the excess carrier;… more