- Fresenius Medical Center (Athens, TX)
- …**LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/ Medicare Services ( CMS )-approved state and/or national certification ... machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system . **RECORD KEEPING:** + Complete and document ongoing… more
- Molina Healthcare (Austin, TX)
- …and demonstrate proficiency in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ... Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing… more
- Kelsey-Seybold Clinic (Cypress, TX)
- …has achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including ... counseling for patients referred to Endocrinology. Clinical responsibilities will include patient management in the clinic with a focus on Chronic disease … more
- Kelsey-Seybold Clinic (Houston, TX)
- …has achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including ... Otolaryngologists. Job responsibilities will include office evaluations, chronic care management , preventive care of both new and established patients,… more
- HCA Healthcare (San Antonio, TX)
- …Advice + Payer denial/DRG downgrade letters + Complex NCD/LCD guidelines, CMS /AHCA policies and regulations + Federal Register, Center for Medicare ... Medicaid Services, American Hospital Association, Food and Drug Administration, Medicare Administrative Contractors and payer websites + Escalates problem… more
- Humana (Austin, TX)
- …data driven methods to develop and influence formulary strategies for Humana's Medicare line of business. + Utilizes broad understanding of pharmacy, managed care, ... pharmacy related field + Experience in Formulary strategy/development and CMS Part D guidance + Experience in analysis and...with staff in different positions and all levels of management positions. + Ability to prioritize, organizes, and executes… more
- Molina Healthcare (Dallas, TX)
- …Action Items (SAIs) including assisting and executing projects and tasks to ensure CMS and State regulatory requirements are met for pre-pay edits, post payment ... and experience. + At least 3 years of Experience with Medicaid and/or Medicare . + Proven experience owning operational projects from concept to execution, especially… more
- Kelsey-Seybold Clinic (Webster, TX)
- …has achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including ... hospital- based responsibilities. Primarily, assisting the physician in evaluation and management of clinic patients to include performing histories and physical… more
- Kelsey-Seybold Clinic (Houston, TX)
- …has achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including ... counseling for patients referred to Neurology. Clinical responsibilities will include patient management in the clinic such as follow up visits from initial… more
- Kelsey-Seybold Clinic (Webster, TX)
- …has achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including ... comprehensive evaluations and ultrasound interpretations. Additional responsibilities include developing co- management pathways for high-risk conditions such as diabetes, hypertension,… more