- ChenMed (Houston, TX)
- …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 ... work closely with the applicable center and market leadership to ensure compliance with guidelines along with participating in risk and quality management programs,… more
- Gentiva (Temple, TX)
- …service codes and clinician assignments. + Support administrative and compliance activities including workflow audits, survey readiness tasks, and documentation ... collection. + Assist with TPE reviews, QAPI efforts, and regulatory compliance . + Ensure infection control standards and universal precautions are consistently… more
- Cardinal Health (Austin, TX)
- …initiatives to optimize cash flow, reduce aging accounts, and ensure compliance with payer and regulatory requirements. **Responsibilities:** + Lead and manage ... for complex or high-dollar claims. + Stay current with payer policy changes, compliance regulations, and industry best practices. + Analyze trends in denials and… more
- Public Consulting Group (Austin, TX)
- …support through review and updating reference data, contractual metrics, and compliance metrics. Ensures accurate RMC support through internal claim errors and ... support through review and updating reference data, contractual metrics, and compliance metrics. Ensures accurate RMC support through internal claim errors and… more
- Molina Healthcare (TX)
- …to identify opportunities for optimization, automation, and process improvement. **Security, Compliance & Risk Management** + Ensure compliance with **HIPAA, ... analytics. + Strong understanding of healthcare environments, including **Medicaid, Medicare , and Marketplace** member and provider engagement models. + Demonstrated… more
- Caris Life Sciences (Irving, TX)
- …metrics, ensuring goals are met for turnaround time, accuracy, and payer compliance . + Collaborate with payers to resolve eligibility discrepancies, denials, and ... for process improvements. + Implement and update policies and procedures to ensure compliance with regulatory and payer requirements. + Train, coach, and mentor team… more
- Humana (Austin, TX)
- …Care Management, and IT application teams to ensure supplier performance and compliance with clinical and regulatory standards. A successful candidate has experience ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Fresenius Medical Center (Irving, TX)
- …nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal ... business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and… more
- Humana (Austin, TX)
- …+ Perform technical assessment and integration of AI hardware, ensuring compliance with security, performance, and regulatory standards for sensitive workloads. + ... to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Fresenius Medical Center (Irving, TX)
- …a licensed nurse under organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. ... direct supervision of the Home Therapies registered nurse (HT RN), in compliance with, and as permissible per state laws, regulations, and policies.** **PRINCIPAL**… more