- Health Care Service Corporation (Richardson, TX)
- …the compliance of the program requirements as required by the applicable state Medicaid or Medicare requirements. Manage the preparation and readiness for ... and ensure ROI. **PREFERRED JOB REQUIREMENTS** **:** + Knowledge of Medicaid and/or Medicare health plan and PBM operations. + Additional degrees or credentials… more
- CVS Health (Austin, TX)
- …Experience or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with ... of the position **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with individuals… more
- Aveanna Healthcare (Corpus Christi, TX)
- …care to infants, children, adolescents, and adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all ... become part of Aveanna's supportive and dynamic environment! As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related… more
- Molina Healthcare (Houston, TX)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials ... Qualifications** * Customer/provider experience in a managed care organization ( Medicaid , Medicare , Marketplace and/or other government-sponsored program), or… more
- Aveanna Healthcare (Dallas, TX)
- …+ Willingness to work an after-hours on-call schedule. Note:As an employer receiving Medicare and Medicaid funds, employees must comply with all health-related ... become part of Aveanna's supportive and dynamic environment. As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related… more
- Molina Healthcare (Austin, TX)
- …Common Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other ... medically appropriate clinical guidelines, Medicaid , Medicare , CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access… more
- CVS Health (Austin, TX)
- …years of clinical practice experience. Two (2) + years of experience in managed care ( Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS or AOA ... one state where we have an Integrated plan. Experience with managed care ( Medicare and Medicaid ) utilization review preferred. **Education** MD (Doctor of… more
- Catholic Health Initiatives (Bryan, TX)
- …with Billing Coordinator referencing necessary pre-transport screening patient information, Medicare and Medicaid Laws/Guidelines updates, and other contractual ... with Billing Coordinator referencing necessary pre-transport screening patient information, Medicare and Medicaid Laws/Guidelines updates, and other contractual… more
- Molina Healthcare (Fort Worth, TX)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive ... including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and… more
- Molina Healthcare (Houston, TX)
- …according to the SIU's standards. Position must have thorough knowledge of Medicaid / Medicare /Marketplace health coverage audit policies and be able to apply ... data from all types of healthcare providers that bill Medicaid / Medicare /Marketplace. **KNOWLEDGE/SKILLS/ABILITIES** + Ensure investigators are managing their… more