- Humana (Austin, TX)
- …community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The Behavioral ... Health Medical Director work assignments involve moderately complex to complex issues...of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare Advantage and Medicaid requirements, and… more
- Humana (Austin, TX)
- …of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims. The Corporate Medical ... Director works on problems of diverse scope and complexity...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis… more
- Highmark Health (Austin, TX)
- …experience in managed care pharmacy + 2 years of clinical account management experience in Medicare as part of the 4 year managed care experience + 2 years of ... experience analyzing pharmaceutical cost of care data **Substitutions** + None **Preferred** + Masters of Pharmacy or Masters of Business Administration + AMCP-ASHP accredited residency in managed care pharmacy + Experience leading or participating in Pharmacy… more
- Humana (Austin, TX)
- …of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests for services. The ... Medical Director work assignments involve moderately complex to complex issues...and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements and will… more
- CVS Health (Austin, TX)
- …pre-certification, and predetermination of covered benefits in the Commercial and Medicare environment. This Medical Director provides subject matter expertise ... Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next...in the United States. In this role as Medical Director MPO (Medical Policy & Operations) you will be… more
- UTMB Health (Galveston, TX)
- …and for directing staff in preparation of these reports. + Supports Director , Finance-Government Reimbursement in preparing annual Medicare , Medicaid and TDCJ ... to implement appropriate processes and procedures to ensure compliance with Medicare and Medicaid regulations. + Supports Director , Finance-Government… more
- Humana (Pearland, TX)
- …and Pearland.** The MarketPoint Career Channel Team is looking for skilled Medicare Sales Field Agents. This is a **field** **-based** role, and candidates ... community. As part of a collaborative team of 8-12 Medicare Sales Field Agents, you'll work under the guidance...under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll… more
- Houston Methodist (Katy, TX)
- …procedures, and provides quality reviews. Reports results of key performance metrics to director on a timely basis. **FINANCE ESSENTIAL FUNCTIONS** + Assists in the ... to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health, SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director ...dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing ... home health, SNF, DME, dual Medicare /Medicaid and Waiver requests. The Medical Director ...dual Medicare /Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided… more