- Apex Health Solutions (Houston, TX)
- …leadership role. Health plan or managed care industry experience preferred (eg, Medicare Advantage, Medicaid, or commercial insurance ). Strong understanding of ... to others; uses resources effectively. Deep understanding of healthcare and insurance financial drivers. Problem Solving - Identifies and resolves problems in… more
- Humana (Austin, TX)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance . + ... internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to… more
- CenterWell (Austin, TX)
- …Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current ... paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **About us**… more
- CenterWell (Austin, TX)
- …Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid ... off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** About Conviva Senior Primary… 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
- Humana (Austin, TX)
- …Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance . + ... **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical… more
- Humana (Austin, TX)
- …organizations in the country. The Healthcare Strategy team supports Humana's Insurance segment. This segment, Humana's largest, comprises the majority of the ... experience leveraging core consulting skills, to support delivering some of the Insurance segment's highest priority projects and initiatives, with an emphasis on … more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …to insurance companies in a timely manner. + Perform follow-up with Medicare , Medicaid, Medicaid, Managed Care, and Commercial insurance companies on unpaid ... Paso **Preferred Qualifications:** + Associate's degree preferred. + Understanding of Medicare , Medicaid eligibility requirements and commercial insurance payer… more
- Humana (Austin, TX)
- …Principal coordinates, implements, and manages oversight of the company's Medicare /Medicaid Stars Program for aligned areas. The Stars Improvement Principal ... role is responsible for supporting the Stars strategy within Insurance Operations, serving as a subject matter expert for...years or more of CMS Stars program experience + Medicare Advantage experience + Previous leadership experience as a… more
- Abbott (Plano, TX)
- …of education and work experience + General knowledge of private insurance , Worker's Compensation and Medicare guidelinespertaining toProspective and ... similar work experience. **Preferred** **Qualifications** + Knowledge of private insurance , Worker's Compensation and Medicare guidelinespertaining toProspective… more