- 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. ... segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement Professional, you… 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. ... You'll play a key role in shaping financial insights, supporting Medicare -related initiatives, and guiding analytical projects that impact business outcomes. +… more
- Centene Corporation (Austin, TX)
- …candidate will have:_** + **_Knowledge of dual contract requirements (eg, Medicare - Medicaid plans)_** + **_Experience managing external audits and communicating ... for its Duals and SMAC regulatory filings. + Manages Duals (and Medicare with D-DSNP specific or separate) compliance reporting responsibilities and respond to… more
- Molina Healthcare (Dallas, TX)
- …representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). M-F from 8am - 4:30pm EST ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and… more
- Molina Healthcare (Houston, TX)
- …Act** cases in accordance with the standards and requirements of Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Responsible for ... coordination of benefits (COB), subrogation and eligibility criteria. * Experience with Medicaid and Medicare claims denials and appeals processing, and… 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** * Manages team ... complicated claims, COB and DRG/RCC pricing). * Experience with Medicaid and Medicare claims denials and appeals processing, and knowledge of regulatory… more
- TEKsystems (Dallas, TX)
- …and submit enrollment and re-enrollment applications for healthcare providers to Medicare , Medicaid , and commercial insurance plans. Maintain accurate and ... provider enrollment, credentialing, or healthcare administration. Strong understanding of Medicare , Medicaid , and commercial insurance enrollment processes.… more
- HCA Healthcare (San Antonio, TX)
- …with the standards of care and meets the requirements or regulations of JCAHO, Medicare , Medicaid , and appropriate licensing or certified boards. The manager is ... the conditions of participation, requirements or regulation of the following: JCAHO, Medicare , Medicaid , Texas State Licensures and Certifications as requires.… more
- Prime Therapeutics (Austin, TX)
- …all provider and member materials and communications, and product ownership for Medicare and Medicaid formularies + Provide consultation and recommendations to ... management experience + Knowledge of the applicable line of business (eg, Medicare , Medicaid , Exchange, Commercial, Employer Group) Every employee must… more
- Humana (Austin, TX)
- …Finance + Accounting/Finance knowledge/experience + Advanced SQL or similar + Medicare / Medicaid experience + Data architecture/solution architecture experience + ... are leading to a better quality of life for people with Medicare , Medicaid , families, individuals, military service personnel, and communities at large. … more