- Molina Healthcare (San Antonio, TX)
- …the medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid , NCQA and other regulatory requirements. + Reviews quality ... Medical license without restrictions to practice and free of sanctions from Medicaid or Medicare . **PREFERRED EDUCATION:** Master's in Business Administration,… more
- Prime Therapeutics (Austin, TX)
- …+ Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid ) + Other duties as assigned **Education & ... organization, or within a highly regulated industry, including experience with Medicare , Medicaid , and the Affordable Care Act (ACA) + Must be eligible… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of Dual contract requirements (eg, Medicare - Medicaid plans)_** + **_Experience managing external audits and communicating ... + Manage approval and submission of timely and accurate D-SNP State Medicaid Agency ("SMAC") contract and regulatory required report deliverables not limited 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. ... health first** The Senior Acquisition Implementation Professional manages all aspects of Medicaid State Implementations, from start to finish, so that it is… more
- Houston Methodist (Houston, TX)
- … cost reports, Federal Tax Returns Health and Human Services (HHS)/Centers for Medicare and Medicaid Services (CMS) reporting, Federal and State Charity ... and accreditation/regulatory/government regulations. **Preferred candidates will have the following:** Medicare and Medicaid Cost Reporting **PEOPLE ESSENTIAL… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …submit to insurance companies in a timely manner. + Perform follow-up with Medicare , Medicaid , Medicaid , Managed Care, and Commercial insurance companies ... Paso **Preferred Qualifications:** + Associate's degree preferred. + Understanding of Medicare , Medicaid eligibility requirements and commercial insurance payer… more
- Humana (Austin, TX)
- …or existing environment while minimizing disruption and mitigating risks + Experience with Medicare and/or Medicaid + Ability to coordinate with development and ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more
- CenterWell (Austin, TX)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare / Medicaid Experience a plus + Current nursing ... experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity +… more
- Humana (Austin, TX)
- …Activation Principal coordinates, implements, and manages oversight of the company's Medicare / Medicaid Stars Program for aligned areas. The Stars Improvement ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … 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. ... submission of bids to support Humana's pricing and product development of Medicare Advantage and Prescription Drug Plans that positively impact the financial… more