- CVS Health (Austin, TX)
- …2+ years of experience within Medicare Part D Stars Program Management, Medicare / Medicaid HEDIS measurement or other government quality program management ... all with heart, each and every day. **Position Summary** Located within the Medicare Stars Program Management team, in this individual contributor role you will… more
- Humana (Austin, TX)
- …of established clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis and ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- Houston Methodist (Katy, TX)
- …needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid programs. + Ensures optimization of timely cash ... Prospective Payment Systems, etc. + Stays informed of the latest Medicare , Medicaid and commercial payor news, updates, and regulations and adjusts processes… 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. ... a part of our caring community and help us put health first** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app hydrated via… more
- Molina Healthcare (San Antonio, TX)
- …documents. + Lead regularly scheduled business meetings. + Interpret and analyze Medicare and Medicaid communications. + Review and interpret internal dashboards ... **JOB DESCRIPTION** **Job Summary** Molina Healthcare's Medicare Compliance team supports Medicare operations for the Molina Medicare product lines. It is a… more
- UTMB Health (Galveston, TX)
- …calculations and estimates and ensures UTMB compliance with Medicare and Medicaid regulations. **Scope:** Institutional **Responsibilities:** ... + Responsible for technical aspects, calculations and analyses of multiple areas of Medicare and Medicaid reimbursement components including, but not limited to,… more
- Molina Healthcare (TX)
- …their financial and clinical performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB ... + 3 - 5 years supervisory experience + Demonstrated understanding of Medicaid and Medicare programs or other healthcare plans + Experience with Databricks +… more
- Abbott (Austin, TX)
- …(CTR). **What You'll Work On** + Review clinical investigative plan and payer policies ( Medicare , Medicare Advantage, Medicaid and Private Payer) to provide ... affect existing and future clinical trials. + Assist sites with Medicare , Medicare Advantage, Medicaid and Private Payor prior authorization,… more
- Humana (Austin, TX)
- …responsible for ensuring the accurate and timely submission of encounter data to Medicaid , Medicare , and DSNP states, while maintaining adherence to all ... Lead is responsible for ensuring the integrity and accuracy of Medicaid and Medicare encounter data across multiple trading partners. This role collaborates with… more
- Humana (Austin, TX)
- … Guidance on following and reviewing home health, SNF, DME, dual Medicare / Medicaid and Waiver requests. The Medical Director provides medical interpretation ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. **Equal… more