• Medical Director - IP Claims Management

    Humana (Austin, TX)
    …service should be authorized. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national ... teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicare Advantage, and Medicaid requirements and will understand… more
    Humana (12/11/25)
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  • Medical Director-Payment Integrity

    Humana (Austin, TX)
    …at the Inpatient level. All work occurs within a context of regulatory compliance , and work is assisted by diverse resources, which may include national clinical ... teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will understand… more
    Humana (12/11/25)
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  • Delivery Senior Manager

    NTT America, Inc. (Plano, TX)
    …Manager to join our team. NTT DATA is seeking to hire a ** Medicare Appeals Clinical Leader** to lead service delivery engagements and improve end-to-end delivery ... of Medicare Appeals. Desire experience specifically for processes for clinical...accordance with federal and state laws. + Identify potential compliance risks and implement corrective actions + Collaborate with… more
    NTT America, Inc. (12/10/25)
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  • Field Access Manager - Arkansas/Oklahoma…

    Merck (Austin, TX)
    …reimbursement issues, and support patient assistance programs, all while ensuring compliance with healthcare regulations. The FAM role is a remote/field-based role ... how the products are covered under the benefit design (Commercial, Medicare , Medicaid) * Answer questions about coverage, including payer-specific access questions… more
    Merck (12/30/25)
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  • Clinical Manager RN

    HCA Healthcare (San Antonio, TX)
    …and delivery of quality interdisciplinary home health care services. Will ensure compliance to federal/state standards and clinical best practices. **What you will ... from Quality Review Specialist) to ensure the medical records reflect compliance with medical necessity, homebound status, visit utilization, and documentation of… more
    HCA Healthcare (12/19/25)
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  • Physician PRN

    CenterWell (Houston, TX)
    …primary care "on-call" program of CenterWell as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your ... Medicine preferred + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    CenterWell (01/06/26)
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  • Primary Care Physician

    CenterWell (El Paso, TX)
    …local primary care "on-call" program of Conviva as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your ... required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    CenterWell (11/26/25)
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  • Primary Care Physician

    CenterWell (Baytown, TX)
    …local primary care "on-call" program of Conviva as needed. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your ... required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    CenterWell (11/18/25)
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  • Physician

    CenterWell (Fort Worth, TX)
    …local primary care "on-call" program of CenterWell as needed. Assures personal compliance with licensing, certification, and accrediting bodies. Spend 100% of your ... **Preferred Qualifications:** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    CenterWell (11/06/25)
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  • Primary Care Physician

    CenterWell (Houston, TX)
    …primary care "on-call" program of CenterWell as needed. . Assures personal compliance with licensing, certification, and accrediting bodies. . Spend 100% of your ... Medicine preferred . Active and unrestricted DEA license . Medicare Provider Number . Minimum of two to five...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    CenterWell (11/05/25)
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