- Humana (Austin, TX)
- …CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial ... filing, reporting & analysis, reserving or trending) **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience working with… more
- Humana (Austin, TX)
- …CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial ... focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience working with… more
- CVS Health (Irving, TX)
- …leaders. Condition-specific Value-Based Care (VBC) models are an expanding focus for Medicare business, with a growing number of Provider Partners and eligible ... on a timely basis. + Educate internal and external stakeholders to ensure compliance with contract terms and expectations. + Work collaboratively to develop analytic… more
- Allied Universal (Mcallen, TX)
- …Overview: Advance Your Career in Insurance Claims with Allied Universal(R) Compliance and Investigation Services. Allied Universal(R) Compliance and ... a career with us and make a difference. **JOB DESCRIPTION:** Allied Universal Compliance and Investigations is seeking candidates to fill the role of the Field… more
- Humana (Austin, TX)
- …o Interview skills and able to conduct a thorough investigation to maintain compliance with Humana and governmental requirements o Able to collaborate with internal ... and external partners (Law Enforcement, Legal, Compliance ). o Comfort with data analysis (Excel, Access, PowerBI),...Clinical Teams o Business areas for all product lines ( Medicare , Medicaid, Commercial) o Industry Trend areas **Use your… more
- Gentiva (Athens, TX)
- …program by managing patient care activities, supervising clinical staff, and ensuring compliance with all company policies and regulatory standards. **$5,000 Sign On ... + Lead and support hospice patient care operations to ensure quality and compliance + Supervise, teach, evaluate, and develop nursing and clinical associates +… more
- Highmark Health (Austin, TX)
- …Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment… more
- Humana (Austin, TX)
- …Accountable for actuarial certifications on rate filings, including attesting to compliance with state and federal rating and benefit regulations. Understands ... **Preferred Qualifications** + Experience with SQL or VBA + Medicare experience Travel: While this is a remote position,...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- CenterWell (Houston, TX)
- …coverage for after-hours urgent phone calls from patients. + Assures personal compliance with licensing, certification, and accrediting bodies. + Spend 100% of your ... pump + Work experience in electrophysiology + Experience managing Medicare Advantage panel of patients with understanding of Best...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Austin, TX)
- …clearly-especially around generative AI. Design for scalability, reliability, and compliance . + **MLOps & DevOps Collaboration** Work with engineering and ... + **Industry Knowledge** : Familiarity with the healthcare sector, specifically Medicare Advantage, and an understanding of regulatory frameworks and market… more
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