- Humana (Austin, TX)
- …medical review by physician or nurse, with a focus on our 5+ million Medicare members. You will also facilitate the delivery of high quality, appropriate, and ... to assist and facilitate new hires and remediation of medical directors performing Medicare utilization management processes and be the liaison for the Medicare … more
- CenterWell (San Antonio, TX)
- …role, you will be required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum of two to five years ... directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care… more
- Humana (Austin, TX)
- …determining objectives and approaches to assignments. This role is within the Medicare Finance organization. This role will be required to collaborate with various ... valuations that help inform financial strategy related to the Medicare Advantage line of business. **Use your skills to...Excel and Power Point + Experience with presentations to senior leaders + Ability to work in a fast-paced… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Senior (Sr.) Accountng and Reporting Analyst position is responsible for identifying and compiling information to effectively report costs ... requests for information. **SERVICE ESSENTIAL FUNCTIONS** + Prepares and submits the annual Medicare cost report for each HM hospital and assists in cost report… more
- Houston Methodist (Houston, TX)
- …internal and external financial and governmental reporting requirements. Requirements include Medicare cost reports, Federal Tax Returns Health and Human Services ... (HHS)/Centers for Medicare and Medicaid Services (CMS) reporting, Federal and State...garnering highest confidence in professionalism and work product by senior leadership + Ability to work under pressure and… more
- CenterWell (Corpus Christi, TX)
- …Care Organization (PCO) is the largest and fastest growing value-based care, senior -focused primary care network in the country. The Primary Care Physician (PCP) ... two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently operates about ... 340+ senior focused primary care centers in 15 states. The...revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims) + Experience with Auditing and… more
- CenterWell (Austin, TX)
- …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... and many other opportunities. Application Deadline: 09-30-2025 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive,… more
- CenterWell (Austin, TX)
- …complex care initiatives to drive quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will ... quality and value drivers in full risk care delivery, ideally in Medicare /seniors + Demonstrated ability to work collaboratively with clinical and operational… more
- Humana (Austin, TX)
- …best practices, and design clinical solutions for members who have Medicare and Medicaid. The Lead Product Manager partners across various multi-disciplinary ... our dual members - members that qualify for both Medicare and Medicaid. The Lead Product Manager sits in...will ensure effective interaction with all organizational levels, including senior and executive level audiences + Proven ability… more