- CenterWell (San Antonio, TX)
- …patient/customer service **Preferred** **Qualifications:** + Knowledge of HEDIS measures and quality indicators + Experience managing Medicare Advantage panel of ... part of our caring community and help us put health first** The Nurse Practitioner (VSP) applies advanced education and clinical competencies to achieve optimal… more
- Humana (Austin, TX)
- …and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination, documentation ... of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied...need it. These efforts are leading to a better quality of life for people with Medicare ,… more
- Banner Health (TX)
- …improvement and quality management . Assists and participates with management through committees to properly educate physicians, nursing , coders, CDM's, ... clinical documentation and billing codes. Works with clinical documentation improvement and quality management staff to: align diagnosis coding to documentation… more
- Aveanna Healthcare (Buda, TX)
- …a FriendBack Job Details Requisition #: 204875 Location: Buda, TX 78610 Category: Nursing Salary: $30.00 - $33.00 per hour Position Details Join a Company That ... Puts People First! Registered Nurse - RN - Immediate Schedules in Buda -...within last 12 months) + Six months prior hands-on nursing experience preferred but not required + Must have… more
- Molina Healthcare (Fort Worth, TX)
- … Nursing , **Preferred Experience** More than five years Case Management experience. Medicaid/ Medicare Population experience with increasing responsibility. ... in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification. To all… more
- Houston Methodist (Houston, TX)
- …registered nurse (RN) responsible for comprehensively planning for case management , which includes care transitions and discharge planning of a targeted patient ... section. + Bachelor's degree preferred **WORK EXPERIENCE** + Three years hospital nursing clinical experience + Case management experience preferred **LICENSES… more
- Humana (Austin, TX)
- …they need, when they need it. These efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service ... help us put health first** The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and...Our nurses are titled Care Managers, because our case management services are centered on the person rather than… more
- Molina Healthcare (Fort Worth, TX)
- … Improvement (QI) leader within the organization, empowered to advise senior management and other departments on Quality strategies and initiatives. This ... programs. + 2 years Medicaid experience + 2 years Medicare experience + 3 years management experience...**Preferred License, Certification, Association** + Certified Professional in Health Quality (CPHQ) + Nursing License (RN may… more
- Elevance Health (Grand Prairie, TX)
- …workload involving complex areas of Medicare part A reimbursement such as Medicare DSH, Bad Debts, Medical Education, Nursing and Allied Health, Organ ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare...perform all duties of lower-level positions as directed by management . + Participate in development and maintenance of Audit… more
- Molina Healthcare (Austin, TX)
- …(QIA) in collaboration with the clinical lead, the medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA ... + Monitors appropriate care and services through continuum among hospitals, skilled nursing facilities and home care to ensure quality , cost-efficiency, and… more