- Danaher Corporation (Houston, TX)
- …of national, regional and local coverage and reimbursement issues for Medicare , Medicaid and Commercial payers through internal meetings, payer research, and ... diagnostics (preferred) + Demonstrated knowledge of all payer segments (eg Commercial, Medicare , Medicaid) + Demonstrated and presentation skills It would be a plus… more
- Kelsey-Seybold Clinic (Houston, TX)
- …insurers to offer value-based commercial health plans and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to ... achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024.… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of Dual contract requirements (eg, Medicare -Medicaid plans)_** + **_Experience managing external audits and communicating with ... Experience with D-SNP SMAC, regulatory requirements and/or operations required + Medicare managed health experience required Pay Range: $86,000.00 - $154,700.00 per… more
- Prime Therapeutics (Austin, TX)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to the ... to the plan + Provide clinical guidance and support for client's Health Insurance Marketplace business + Manage incoming requests for information from the plan… more
- Evolent (Austin, TX)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
- Kelsey-Seybold Clinic (Houston, TX)
- …insurers to offer value-based commercial health plans and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to ... achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024.… more
- Molina Healthcare (Hidalgo, TX)
- …The Specialist will collaborate with internal teams (Quality, Provider Relations, Medicare , and Marketplace) to align activities and ensure a cohesive approach. ... transportation. **Preferred License, Certification, Association:** + Active Life & Health Insurance + Market Place Certified To all current Molina employees: If… more
- Evolent (Austin, TX)
- …current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an "excluded person" by the ... Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or legal action by a state… more
- Kelsey-Seybold Clinic (Webster, TX)
- …insurers to offer value-based commercial health plans and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to ... achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024.… more
- Kelsey-Seybold Clinic (Webster, TX)
- …insurers to offer value-based commercial health plans and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to ... achieved an overall rating of 5-out-of-5-stars as part of the Centers for Medicare and Medicaid CMS annual assessment for eight consecutive years, including 2024.… more