- ChenMed (Houston, TX)
- …5 days. + Orders have been approved (when needed). + Schedules patient ( Preferred Providers List of Specialist ) and notifies them of appointment information, ... with Web IVRs and obtaining referrals/authorizations for multiple payers strongly preferred + Healthcare experience within the Medicare Advantage population… more
- Molina Healthcare (Dallas, TX)
- …Certification, Association** + AAPC Certified Medical CPC, CPMA, CPCO or similar specialist preferred + Certified Fraud Examiner and/or AHFI professional ... oral and written communication skills and presentation skills. + Medicare and Marketplace experience **JOB QUALIFICATIONS** **Required Education** High School… more
- Humana (Austin, TX)
- …approvals, as well as modeling financial impact of emerging therapeutics across Medicare and Medicaid LOBs + Researches and analyzes drugs and emerging therapeutics, ... to an organization focused on continuously improving consumer experiences ** Preferred Qualifications** + PharmD + Health Plan experience +...+ PharmD + Health Plan experience + Knowledge of Medicare as it relates to pharmacy + Six Sigma… more
- HCA Healthcare (San Antonio, TX)
- …Consumer Discounts + Retirement readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, ... regarding deficiencies or OASIS corrections (with feedback from Quality Review Specialist ) to ensure the medical records reflect compliance with medical necessity,… more
- Abbott (Plano, TX)
- …a week position. Preferred hours 8am to 5pm. As a PTA Specialist you are responsible for facilitating and assisting Abbott patients with the pre-certification, ... **The Opportunity** Our location in **Plano, TX** currently has an opportunity for a **Patient Therapy Access** ** Specialist ** (PTA). This is an in office 5 days… more
- Molina Healthcare (Austin, TX)
- …cost-effective member care. Candidates with UM and Appeals experience are highly preferred Work hours: Monday- Friday 8:00am - 5:00pm Central time Remote position ... Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other medically… more
- Molina Healthcare (TX)
- …compliance with the National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all ... Care Management & Waiver Service Auditing experience is highly preferred . Work hours: Monday - Friday 8:00am - 4:00pm...+ Assists in preparation of documents for Centers for Medicare and Medicaid Services (CMS), state Medicaid, National Committee… more
- CVS Health (Austin, TX)
- …within budgeted costs. **What you will do** + Acts as a top-level specialist on project management and develops a comprehensive plan that encompasses objectives, ... Qualifications** + Pharmacist + 7-10 years work experience in healthcare + Medicare and/or Medicare -Medicaid Integrated Product Experience + Experience with Part… more
- Evolent (Austin, TX)
- …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... (5) years' experience in the practice of Cardiology is preferred + Not under current exclusion or sanction by...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Banner Health (TX)
- …least 1 year of Urology coding experience** to join our talented team. ** Preferred experience in Surgical Urology and Gynecology Oncology and coding, knowledge and ... coding (clearly reflected in your attached resume);** + **Surgical Urology experience preferred ;** + **Must be currently certified through AAPC or Ahima, as defined… more