- Sedgwick (Austin, TX)
- …Fortune Best Workplaces in Financial Services & Insurance Nurse Allocator- RN Medicare Compliance **Prior medical-set-aside experience highly desired for this ... review, and analysis and interpretation of interventions for the preparation of Medicare Set-Aside allocations. **ARE YOU AN IDEAL CANDIDATE?** We are looking for… more
- Centene Corporation (Austin, TX)
- …and leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions. + Leads ... Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance ...(and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to inquiries from state… more
- Elevance Health (Houston, TX)
- …of managerial experience is strongly preferred + Experience with IRE/Maximus and Medicare compliance , programs, guidelines, and processes are strongly preferred. ... and operational and plan risk, ensures quality, and regulatory compliance . This role specifically oversees the IRE Team. **How...regulated audits. + Oversight of the IRE portions of Medicare audits and universe production. + Serves as a… more
- UTMB Health (Galveston, TX)
- …government payor reimbursement-related calculations and estimates and ensures UTMB compliance with Medicare and Medicaid regulations. **Scope:** Institutional ... takes necessary actions to implement appropriate processes and procedures to ensure compliance with Medicare and Medicaid regulations. + Supports Director,… more
- Elara Caring (Harker Heights, TX)
- …staffing levels at branch locations to meet patient needs. + Ensures compliance of current Medicare , Medicaid, and third-party reimbursement regulations and ... all documentation is accurate, complete, timely and adheres to Medicare guidelines. + Assures compliance with the requirements of state licensure, Medicare … more
- Sedgwick (San Antonio, TX)
- …and laws + Knowledge of medical terminology for claim evaluation and Medicare compliance + Knowledge of appropriate application for deductibles, sub-limits, ... SIR's, carrier and large deductible programs. + Strong oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Strong organizational skills + Strong interpersonal skills + Good negotiation skills +… more
- HCA Healthcare (Conroe, TX)
- …American College of Cardiology, Society of Chest Pain Centers and governmental regulation for Medicare compliance . Manages all CV Data to include ACC, Action and ... STS data registries. **What you will do in this role:** + Develops and supports education to meet all requirements of Chest Pain Accreditation. + Develops and recommends protocol/guidelines for best practice of the cardiac patient across the continuum of care.… more
- Prime Therapeutics (Austin, TX)
- …analytical skills **Preferred Qualifications** + PBM/health care experience related to Medicare , Medicaid, Commercial, HIM + Certified Compliance and Ethics ... passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Risk Assessment and Oversight) - Remote **Job Description** The Senior… more
- CVS Health (Austin, TX)
- …talent! We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist. The position will be a part of a specialized team ... who will focus on educating existing Medicare members on available plan offerings to help meet...selling applicable products to existing members. + Maintaining high compliance commitment and standards with a robust knowledge with… more
- CVS Health (Austin, TX)
- …Leads the strategy, design, development and life cycle management of Aetna Medicare products that serve Medicare Advantage populations, including Chronic Care ... care objectives. Working cross-functionally with Duals Center of Excellence, clinical, compliance , analytics and network teams, the Senior Manager drives innovation… more