- Elevance Health (Grand Prairie, 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
- CVS Health (Austin, TX)
- …with provider engagement, relations, or account management. + Working knowledge of Medicare contracts. + An understanding of value based contracts, how they work, ... what is the value. + Strong presentation skills, the ability to communicate effectively. + Mastery of problem solving and decision making skills + Strong MS Office skills. Preferred Qualifications: + The ability to use data to tell a story. + Mastery of growth… more
- Centene Corporation (Austin, TX)
- …the Continental US. Ideal candidate will have a strong background in Medicare , Medicaid, and/or Dual Eligible Special Needs Plans (D-SNP). Preferred experience in ... writing and copy editing as well as Smartsheet and Workfront. _** **Position Purpose:** Plan, organize, monitor, and oversee complex projects utilizing cross functional teams to deliver defined requirements and meet company strategic objectives. + Manage the… more
- CVS Health (Austin, TX)
- …of 3 years managing/leading a team. + Experience working in Medicare , Medicaid, or Commercial Health Insurance. **Preferred Qualifications** + Experience working ... in credentialing operations. + Strong written and verbal communication. **Education** + Bachelor's degree preferred or a combination of professional work experience and education. **Pay Range** The typical pay range for this role is: $67,900.00 - $199,144.00… more
- Genesis Healthcare (TX)
- …Nurse or equivalent professional license (ie Physical Therapist) *Must have Medicare and State-specific Medicaid experience (as applicable). *Must be willing to ... travel as this position requires an onsite presence the majority of the time. Benefits *Variable compensation plans *Tuition, Travel, and Wireless Service Discounts *Employee Assistance Program to support mental health *Employee Foundation to financially… more
- Elara Caring (Texarkana, TX)
- …2 years of coordinating, and management experience is preferred + Knowledge of Medicare and Medicaid, home health care benefits, policies and procedures + Excellent ... computer and communication skills, with ability to work in fast-paced environment + Reliable transportation to perform job responsibilities You will report to the Branch Director, Alternative Branch Director, or Regional Branch Director. _This is not a… more
- Philips (Houston, TX)
- …evidence and obtaining medical record documentation. + Be an expert on Medicare , Medicaid and private insurance coverage-criteria for InCourage vest therapy. Be able ... to effectively educate healthcare teams in identifying patients who meet coverage criteria. + Ability to analyze data to effectively target priority healthcare teams and create sales call routing. Capable to be flexible and adjust routing to fit pipeline… more
- Houston Methodist (Houston, TX)
- …care and ensures prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as management. **PEOPLE ESSENTIAL ... guidelines. Manages assigned patients and communicates and collaborates with the case manager to assist with appropriate interventions to avoid denial of payment. +… more
- HCA Healthcare (Austin, TX)
- …Performs in accordance with physician's orders and under the supervision of the Clinical Manager . **What you will do in this role** : + Assesses home care patients ... + Communicates significant findings, problems and changes to Clinical Manager and physician, and documents all findings, communications, and appropriate… more
- Molina Healthcare (San Antonio, TX)
- …Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay ... years of experience as a Business Analyst or Program Manager in a Managed Care Organization (MCO) or health...or health plan setting, including experience in Medicaid and/or Medicare , or equivalent combination of relevant education and experience… more