- Molina Healthcare (Austin, TX)
- …health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric ... compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). * Assists with the recruitment and orientation… more
- Evolent (Austin, TX)
- …care is delivered for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal role in advancing value-based ... of oncology care delivery** . + Not under sanction or exclusion from Medicare /Medicaid programs. To ensure a secure hiring process we have implemented several… more
- CVS Health (Austin, TX)
- …it all with heart, each and every day. **Position Summary** The Lead Director , Provider Portal Strategy & Operations is responsible for the strategic leadership and ... oversight of Aetna's three primary provider portal solutions: Availity Commercial/ Medicare Portal, Availity Medicaid Portal, and DentalXchange Dental Portal. This… more
- Texas Health Resources (Bedford, TX)
- Nursing Director Women's and Children _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified ... specialty 12 Months Preferred Skills Knowledge of industry standards JCAHO, Medicare , OSHA, Regulatory standards for affected area of responsibility. Knowledge of… more
- Texas Health Resources (Denton, TX)
- Director Nursing Perioperative _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for qualified candidates like ... within 12 months of hire Skills Knowledge of industry standards JCAHO, Medicare , OSHA, Regulatory standards for affected area of responsibility. Knowledge of… more
- USAA (San Antonio, TX)
- …makes us special and impactful. **The Opportunity** USAA is seeking a talented ** Director , Retirement Income** to lead multiple teams of Health, Life or Retirement ... with Legal, Risk and Compliance on interpretation of CMS (Center for Medicare and Medicaid Services) rules to provide guidance and clarification to executive… more
- BrightSpring Health Services (Harlingen, TX)
- …with Company policies and procedures, state licensure and regulations, Medicaid and Medicare standards, as well as state reimbursement regulations + Leading case ... conferences and other client-related meetings + Chairing committees as appropriate, safety, infection control, incident review, and human rights committees + Facilitating communication and serving as a liaison between and among nursing and direct care staff,… more
- Molina Healthcare (Fort Worth, TX)
- …clinical leadership and quality improvement teams. * Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. * Reviews quality ... referred issues, focused reviews and recommends corrective actions. * Conducts retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as credentialing, Pharmacy… more
- AdventHealth (Burleson, TX)
- …comply with external accreditation standards, state and federal laws, and Medicare conditions of participation. This role ensures administrative interface with the ... community, including members of the medical and allied health staff, medical staff leadership, related offices, health agencies, and the public. In addition, this position assures and establishes rapport, maintains effective lines of communication, and… more
- Molina Healthcare (Dallas, TX)
- …successful launches of new processes, systems, and operational models across Medicaid, Medicare , and Marketplace lines of business. We are seeking a leader with ... proven experience in **launch planning, execution, and post-implementation stabilization** . **Key responsibilities include:** + Leading operational readiness efforts for new processes, systems, and operational initiatives across provider data and… more