- Molina Healthcare (Fort Worth, TX)
- …gains, audit readiness, and measurable member-experience improvements. You'll begin as a senior individual contributor with the charter to build a focused CTM ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (San Antonio, TX)
- …field of knowledge although they may have technical team members. Senior Program Management professional. Responsible for overall governance across all operational ... gaps and barriers in implementation and compliance to AVP, VP and senior management + Consultative role, develops business case methodologies for programs, develops… more
- Molina Healthcare (Dallas, TX)
- …throughout the project. + Create compelling presentations for Internal Customers, Senior Leaders and Sales Teams, which tell the analytic story, demonstrating ... their value by providing actionable insights with recommendations + Capitalize on opportunities to cross-sell Analytic Tools and Solutions to existing Internal Customers, market the value of analytics services across the enterprise + Integrates work with other… more
- CVS Health (Austin, TX)
- …population health platform to support the delivery of high quality care to the Medicare population. As a Senior Product Manager within the Patient Experience and ... medical costs and provides an unmatched experience for adults on Medicare in medically underserved communities. By providing holistic, comprehensive and integrated… more
- CVS Health (Austin, TX)
- …population health platform to support the delivery of high quality care to the Medicare population. As a Senior Technical Product Manager, you will be ... for driving the strategic direction of our Stars data. Through partnership with senior business and engineering leaders, you will oversee the planning and execution… more
- CVS Health (Austin, TX)
- …Module (CTM) Senior Coordinator, you will be part of the Medicare Complaints Tracking Module (CTM) Team, responsible for researching and resolving Medicare ... complaints received via the Centers for Medicaid and Medicare Services (CMS). In this role, you will manage...In this role, you will manage a queue of Medicare complaints. These complaints can include various issues ranging… more
- Providence (TX)
- …Employment Practices, Fiduciary, Property, Cyber, Managed Care, and Auto Claims. The Senior Quality Analyst assists the Claims leaders in managing a quality ... with laws and regulations pertaining to self-insured health care organizations. The Senior Quality Analyst is also responsible for maintaining a claims quality… more
- Humana (Austin, TX)
- …of our caring community and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission ... and reconciliation of encounter submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data, and… more
- NTT America, Inc. (Plano, TX)
- …adaptable, and forward-thinking organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is seeking to hire a ... ** Medicare Appeals Clinical Leader** to lead service delivery engagements...recommendations and interpretations of records. + Prepare reports for senior management on appeal trends and compliance status. **Requirements:**… more
- Ensono (Houston, TX)
- Senior Systems Engineer - IAMRemote - United StatesJR012224 At Ensono, our **Purpose is to be a relentless ally, disrupting the status quo and unleashing our clients ... **About the role and what you'll be doing:** The Senior Systems Engineer - IAM is responsible for managing...pass related background checks including but not limited to Medicare and Medicaid and VA **Preferred Skills:** + Experience… more
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