• Senior Network Provider Manager , National…

    CVS Health (Austin, TX)
    …with heart, each and every day. **Position Summary** **The Medicaid Senior Manager , Network Management:** * Negotiates, executes, conducts high level review and ... * Highly organized and self-driven. **Preferred Qualifications** * Knowledge of Medicare and commercial programs and related subject matter. **Education** Bachelor's… more
    CVS Health (08/13/25)
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  • Manager , Operations -System Operations…

    Molina Healthcare (San Antonio, TX)
    …type management responsibility. 5 years progressive experience supporting a Medicaid,. Medicare and Marketplace or large claims processing environment with ... apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer… more
    Molina Healthcare (07/31/25)
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  • IT Business Systems Analyst Sr - Medicaid Pharmacy…

    Prime Therapeutics (Austin, TX)
    …Title** IT Business Systems Analyst Sr - Medicaid Pharmacy Implementations - Remote **Job Description** The IT Business Systems Analyst (BSA) Sr is responsible ... resource needs; collaborate with Business Systems Analyst Resource Lead or Resource Manager to determine work assignments within project + Educate and advance… more
    Prime Therapeutics (08/27/25)
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  • Non-Clinical Coding and OASIS Review…

    BAYADA Home Health Care (Austin, TX)
    …requirement.** BAYADA Home Health Care is hiring a full time OASIS Review and Coding Manager . The OASIS and Coding Review Manager provides support to all BAYADA ... Home Health Care Medicare service offices by monitoring Outcome and Assessment Information...also available). **BAYADA Perks:** + This role is **fully remote ,** candidates may be based anywhere in the US… more
    BAYADA Home Health Care (08/15/25)
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  • RN Lead, HCS (Clinical) Remote with field…

    Molina Healthcare (Fort Worth, TX)
    …diverse communities! Hours: Monday - Friday 8:00 AM to 5:00 PM EST Remote position with 25% field travel MA RN license **KNOWLEDGE/SKILLS/ABILITIES** + Assists in ... that involve clinical HCS staff. Communicates findings to the Supervisor or Manager , HCS Department for resolution. + Maintains a minimal caseload as determined… more
    Molina Healthcare (08/15/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (TX)
    …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with… more
    Molina Healthcare (07/31/25)
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  • Delivery Senior Manager

    NTT America, Inc. (Plano, TX)
    …adaptable, and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a ** ... Medicare Appeals Clinical Leader** to lead service delivery engagements...delivery of services. This position is eligible for company benefits including medical, dental, and vision insurance with an… more
    NTT America, Inc. (06/12/25)
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  • Sr Digital Marketing Specialist ( Remote )

    Molina Healthcare (TX)
    …**Highly Qualified Candidates Will Have the Following Experience-** Digital Tag Manager Programs Salesforce Marketing Cloud Google or Adobe analytics (or similar) ... Google AdWords, Tag Manager systems, (Adobe or Google) CMS (content management system)...a desire to improve processes **Preferred:** + Medicaid or Medicare Health Plan experience + Strong analytical skills **PHYSICAL… more
    Molina Healthcare (08/14/25)
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  • Lead Analyst, Technical Configuration Information…

    Molina Healthcare (Dallas, TX)
    …system requirements of customers as it pertains to contracting, benefits , prior authorizations, fee schedules, and other business requirements. ... complex MRDT and other configuration update scripts + Assists manager in establishing standards, guidelines, and best practices for...proof of concept tests without needing mentoring + Eg, Medicare Exclusion POC + Acts as a team lead,… more
    Molina Healthcare (08/27/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Austin, TX)
    …Apply now for immediate consideration. OASIS Review, Utilization Review, Quality Assurance, Remote , Home Health Coding, Coder, Medicare **As an accredited, ... opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely....they need. **BAYADA Perks:** + This is a fully remote , permanent salaried position. + Base Salary: **$74,000** /… more
    BAYADA Home Health Care (08/15/25)
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