- CVS Health (Richardson, TX)
- …Formulary Analyst, you will perform a critical role in the analysis of Medicare and Commercial formularies to determine client eligibility for rebates with respect ... by manufacturers and clients. + Adhering to quality control process in review of formulary rebate eligibility and contributing to enhancing our quality control… more
- Kelsey-Seybold Clinic (Houston, TX)
- …multidisciplinary team, and experience with clinical pathology to include peripheral smear review and knowledge of CLIA regulatory requirements as it applies to ... compliance with departmental key performic indicators such as turnaround time and peer review metrics. + Perform frozen sections on a rotating basis. + Perform rapid… more
- MD Anderson Cancer Center (Houston, TX)
- …technical and administrative levels. 2. Must be able to visually review , evaluate and correctly interpret medical records, patient date, immunology laboratory ... data with research findings. 6. Must be able to review and update the procedure manual to maintain high...and that laboratory complies with the CAP, JCAHO, FDA, Medicare , and CLIA regulations for accreditation. 9. Must be… more
- Prime Therapeutics (Austin, TX)
- …Subject Matter Expertise in their areas of focus (Affordable Care Act, Medicare , Medicaid, Corporate Compliance, Compliance Assessment or Services etc.) + Develop ... procedures (Standard Operating Procedures, Desk Top Procedures, etc.) and review applicable operations teams' documentation; develop regulatory monitoring and… more
- Conduent (TX)
- …Enrollment, Eligibility, Invoicing, Claims, and related topics **. ** Fully explain the Medicare Part D and or Part C Medicare Advantage Programs. Answering ... members issue by answering their questions. Navigate the Members' plan benefits, review Client's policy and procedures, while using resources provided by the Client… more
- Elevance Health (Houston, TX)
- …in medication use quality improvement programs, analyzing pharmacy spend and trends, and Medicare Star Part D measures strongly desired. + Experience working with ... Medicare and Commercial providers strongly preferred. + PBM or...or territory of the United States when conducting utilization review or an appeals consideration and cannot be located… more
- Aveanna Healthcare (Temple, TX)
- …and "Re-evaluations" to transition patients from facilities to home care. + Review physicians' orders and update care plans and documentation as needed. + ... to infants, children, adolescents, and adults. Note: As an employer receiving Medicare and Medicaid funds, Aveanna employees must comply with all health-related… more
- Healthfirst (TX)
- …CMS and New York State regulations, job aides and HF policies. This includes review of performance audit reports in order to maintain superior and accurate care data ... programs such as MAP or MLTC + Knowledge of Medicare Regulations related to Long Term Care + Experience...care plan + Understanding of health plans such as Medicare , Medicaid and/or Managed Long-Term Care Plan (MLTCP) +… more
- HCA Healthcare (Denton, TX)
- …with the patient, including having the Patient Choice letter signed. + Monitors Medicare patient's planned discharge dates and delivers the Important Medicare ... to apply for our Case Management Clerical Asst opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock… more
- Kelsey-Seybold Clinic (Houston, TX)
- …follow-up radiation oncology patients. + Order appropriate diagnostic studies + Review diagnostic test results and implement appropriate treatment. + Interpret and ... and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with… more