- 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
- Humana (Austin, TX)
- …hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other ... Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid , or Commercial health insurance. +… 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. ... Responsible for end to end market support for assigned Medicaid markets to ensure markets achieve their VBP contract...changes to existing VBP models + Coordinate internally with Medicaid VBP model design, contracting, and operations and analytics… 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. ... of everything it does. Are you passionate about the Medicare population, looking for a role in management with...self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of … 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. ... our caring community and help us put health first** This role supports Medicaid state reporting initiatives for its managed care operations across multiple states.… more
- Merck (Austin, TX)
- …on how the products are covered under the benefit design (Commercial, Medicare , Medicaid ) * Answer questions about coverage, including payer-specific access ... matter expert on access and affordability challenges across various payer types, including Medicare , Medicaid , and commercial plans * Educate and update HCPs on… more
- Intermountain Health (Austin, TX)
- …alignment with ICD-10-CM and Official Coding Guidelines as determined by Centers for Medicare and Medicaid Services (CMS), National Center for Health Statistics ... AND Demonstrated knowledge of government benefits and regulations related to Medicare , Medicaid or the ACA. AND Demonstrated knowledge of queries. **_Preferred… more
- CVS Health (Austin, TX)
- …able to manage multiple health plan clients across multiple lines of business including Medicare , Medicaid , Exchange, and Commercial. This is a remote role, open ... + Demonstrated understanding of CVSH clinical portfolio, marketplace segments dynamics ( Medicare , Medicaid , Exchange, and or Commercial) and industry trends… 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 ... to the general ledger. + Analyze and interpret Center for Medicare and Medicaid Services and Department of Insurance regulations to establish required… more
- Humana (Austin, TX)
- …new drug approvals, as well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more