- Humana (Austin, TX)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... teaching conferences, and other reference sources. Medical Directors will learn Medicare , Medicaid, and Medicare Advantage requirements and will understand… more
- Humana (Austin, TX)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board… more
- San Antonio Behavioral Health (San Antonio, TX)
- …be expected to do presentations as directed. Working knowledge of criteria for Medicare , Medicaid, HMO, and private insurance carrier's coverage details. * ... recommendations for adjustments or improvements in treatment plans. * Verify insurance coverage and benefits to determine eligibility for services. * Communicate… more
- Humana (Austin, TX)
- …of the responsibilities: + Engage with the producers and the Center for Medicare and Medicaid Services/Department of Insurance regulations specific to them if ... the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance... Medicare and Medicaid Services and Department of Insurance regulations to establish required appointment fees for producers… more
- Molina Healthcare (Houston, TX)
- …Education** BA Degree or related experience **Required Experience** * 4-7 years Medicare , Medicaid, managed care or other health/ insurance related sales ... or relationship ended * Work as liaison between Molina and/or National Medicare Broker/FMO, Exchange GA, sales agents and other departments (ie Membership… more
- Elevance Health (Denison, TX)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... federal health programs. The **Audit and Reimbursement Senior** will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for … more
- Health Care Service Corporation (Richardson, TX)
- …management and problem solving skills. **Preferred Job Qualifications:** + Health insurance or healthcare industry experience supporting Medicare Advantage + ... the team to support divisional short and long-term initiatives related to Medicare provider network strategy and leverage analytics to drive provider network… more
- Humana (Austin, TX)
- …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 ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Elevance Health (Denison, TX)
- **Audit & Reimbursement III- Medicare Cost Report Audit** **_Location:_** _This role enables associates to work virtually full-time, with the exception of required ... member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services… more
- Humana (Austin, TX)
- …customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact ... self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ...be willing to relocate** + **Active Health & Life Insurance Licenses** + 2 or more years of sales… more