- Evolent (Austin, TX)
- …under 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 ... 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
- Gentiva (Athens, TX)
- …and external providers + Ensure adherence to hospice industry regulations including Medicare , Medicaid , JCAHO, ACHC **About You** **Qualifications - What You'll ... Manage clinical and administrative workflows, including referrals, DME pickups, Medicare eligibility, insurance verification, and patient benefit tracking +… more
- Humana (Austin, TX)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... 2+ years of actuarial experience in healthcare + SAS or other coding skills + Medicare experience + Familiarity with CMS Star Ratings Travel: While this is a remote… more
- CVS Health (Austin, TX)
- …Qualifications** + Pharmacist + 7-10 years work experience in healthcare + Medicare and/or Medicare - Medicaid Integrated Product Experience + Experience ... with Part D Coverage Determination, Appeals and Grievances and/or Formulary Administration regulatory requirements and audit management + Experience with Part C & D reporting requirements + 3+ years serving as project lead + Adept at problem solving and… more
- Houston Methodist (The Woodlands, TX)
- …by capacity to prioritize multiple tasks and role components + Knowledge of Medicare , Medicaid and Managed Care requirements + Comprehensive knowledge of ... if needed, and informs management of the possible need for issuing Medicare Hospital Initiated Notice of Non-coverage. + Applies approved utilization criteria to… more
- Humana (Austin, TX)
- …efforts are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. ... + **Industry Knowledge** : Familiarity with the healthcare sector, specifically Medicare Advantage, and an understanding of regulatory frameworks and market… more
- Evolent (Austin, TX)
- …under 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 ... 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
- Evolent (Austin, TX)
- …under 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 ... 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
- Houston Methodist (The Woodlands, TX)
- …focus and application of positive language principles + Comprehensive knowledge of Medicare , Medicaid and Managed Care requirements + Comprehensive knowledge of ... if needed, and informs management of the possible need for issuing Medicare Hospital Initiated Notice of Non-coverage. + Applies approved utilization criteria to… more
- Health Care Service Corporation (Richardson, TX)
- …criticism + Experience in the Agile methodology + Good understanding of Medicare / Medicaid Healthcare data + Demonstrate mentality of building well architected ... Experience in Healthcare Claim or Enrollment functions. + Experience supporting Medicare technology platforms \#INCR \#LI-BS1 \#LI-Hybrid **Are you being referred to… more