- Gentiva (Lubbock, TX)
- …Group (IDG), as assigned, including presiding over IDG, presentation of patients for review , coordination of minutes, review of patient charts to note and ... new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining authorization and reauthorization as needed,… more
- Prime Therapeutics (Austin, TX)
- …strategy. This role provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality ... goals + Drive the client quality strategy for all lines of business ( Medicare , Medicaid, Commercial/HIM); serve as primary point of contact and subject matter expert… more
- Prime Therapeutics (Austin, TX)
- …lines of business (Employer Markets, Health Insurance Marketplace (HIM), Commercial, Medicare , and Medicaid). This individual is the primary relationship and ... Lead retention efforts for Employer Markets, Health Insurance Marketplace, Commercial, Medicare , and Medicaid health plan clients; drive the adoption and consistent… more
- Gentiva (Terrell, TX)
- …Group (IDG), as assigned, including presiding over IDG, presentation of patients for review , coordination of minutes, review of patient charts to note and ... new physicians and facilities, durable medical equipment (DME) pickup, Medicare patient eligibility, obtaining authorization and reauthorization as needed,… more
- Molina Healthcare (Austin, TX)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care and services… more
- Elevance Health (Houston, TX)
- …member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services ... issues as assigned. + Participates in special projects and review of work done by lower level auditors as...a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience,… more
- CenterWell (Grand Prairie, TX)
- …defined by Clinical Leadership. Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues. Participates in potential ... be screened for TB **Preferred Qualifications:** Active and unrestricted DEA license Medicare Provider Number Medicaid Provider Number Minimum of two to five years… more
- CenterWell (San Antonio, TX)
- …defined by Clinical Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues. + Participates in potential ... role, you will be required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum of two to five years… more
- Molina Healthcare (Austin, TX)
- …or relationship ended * Work as liaison between Molina and/or National Medicare Broker/FMO, Exchange GA, sales agents and other departments (ie Membership ... with projects: o Competitive benefit comparison o Monthly activity submission review o Assist with provider presentations * Collaborate effectively with Community… more
- CenterWell (Beaumont, TX)
- …defined by Clinical Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues. . Participates in potential ... Medicine, Internal Medicine or Geriatric Medicine. Active and unrestricted DEA license . Medicare Provider Number . Medicaid Provider Number . Minimum of two to five… more