- ABBTECH Professional Resources, Inc. (Austin, TX)
- …impact as a Tableau/Data Visualization and Reports Analyst supporting the Centers for Medicare & Medicaid Services ( CMS ). It's your place to make meaningful** ... load with Apex Data Loader.** Healthcare Service Industry and/or Center for Medicare and Medicaid Services ( CMS ) experience.** Experience mentoring junior level… more
- CenterWell (Austin, TX)
- …DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare ... in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
- CenterWell (Austin, TX)
- …procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare ... in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part… more
- Molina Healthcare (TX)
- …to achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services ( CMS ) and State regulatory requirements are met ... **Job Qualifications** **REQUIRED QUALIFICATIONS:** + Experience demonstrating knowledge of CMS Guidelines, MCG, InterQual or other medically appropriate clinical… more
- Houston Methodist (Houston, TX)
- …and kidney anatomy, measurements, and abnormal findings. + Operates within Centers for Medicare & Medicaid Services ( CMS ), OPTN, Health Insurance Portability and ... CMS , and Medicaid to ensure proper department financial management , compliance with all governmental reporting requirements, and proper quality outcomes… more
- CVS Health (Houston, TX)
- …of quality, sales effectiveness, retention, secret shopper initiatives, and state, federal, and CMS requirements for Medicare sales agents and programs + 0-3 ... and retain through the use of the Aetna IVL Medicare product portfolio.This role will deploy an operating model...integrated tech stack the call interactions, COIs, and lead management protocols with new and existing members. + Develop,… more
- Apex Health Solutions (Houston, TX)
- …technicians) in all aspects of pharmacy operations and services including Medicare part D oversight, coverage determination and re-determination (appeal) process, ... workflow management and direct communication to all applicable parties (internal...Eligibility Reconciliation, coverage determination and redetermination based on specific CMS required guidelines. Leads and support the creation, maintenance,… more
- Evolent (Austin, TX)
- …from authoritative sources, including the American Medical Association (AMA), Centers for Medicare & Medicaid Services ( CMS ), Food and Drug Administration (FDA), ... seek to connect the pieces of fragmented health care system and ensure people get the same level of...culture. **What You'll Be Doing:** **Senior Scope Analyst, Scope Management ** The Specialty Scope Management team is… more
- Molina Healthcare (Fort Worth, TX)
- …to achieve operational goals and executes tasks and projects to ensure Centers for Medicare & Medicaid Services ( CMS ) and State regulatory requirements are met ... including assisting and executing projects and tasks to ensure CMS and State regulatory requirements are met for pre-pay...At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept… more
- Houston Methodist (Baytown, TX)
- …knowledge of regulatory and accreditation requirements (such as Centers for Medicare /Medicaid Services/ CMS , The Joint Commission, DNVGL NIAHO/ISO 9001 and/or ... improvement of compliance with standard requirements, including ISO 9001 Quality Management . + Conducts ongoing monitoring, measurement and analysis of survey data… more