- Molina Healthcare (Fort Worth, TX)
- …+ Generates and prepares provider-related data and reports in support of Network Management and Operations areas of responsibility (eg, ... Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with… more
- Humana (Austin, TX)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...Health System. Humana takes the lead in providing administrative support in various areas including HR. DVACO's MSSP participation… more
- ChenMed (Houston, TX)
- …Checklist. + Communicates alternative/approvals to Referral Coordinator. + Follows up with MMD/ Specialist /MND if no response after 24hours. + Calls and follows up ... and higher level of satisfaction with key specialists with support from network director or associate director. + Conducts...entered into HITS prospectively. + Works with tier2/tier 3 specialist to make sure our patients are seen working… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) responsible for promoting the achievement of ... all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles and is responsible for facilitating appropriate length of… more
- Molina Healthcare (San Antonio, TX)
- **Job Description** **Job Summary** Provides lead level support as a highly capable business analyst who serves as a key strategic partner in driving health plan ... Ownership** + Assists and executes tasks and projects to ensure Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements are met for Pre-pay… more
- HCA Healthcare (San Antonio, TX)
- …Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny and adoption assistance. ... banking partnerships + Education assistance (tuition, student loan, certification support , dependent scholarships) + Colleague recognition program + Time Away… more
- Banner Health (TX)
- …for anywhere from 1 - 3 months according to individual needs, with continued support throughout your career here! This is a fully remote position and available if ... have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding… more
- Molina Healthcare (Dallas, TX)
- …thought partner to health plan leadership and provide well-reasoned recommendations that support short- and long-term business goals. + Partner with Network to ... + Partner with finance and compliance to develop business cases and support reporting that ties operational outcomes to financial targets. **Applied Analytical … more
- Adecco US, Inc. (Irving, TX)
- …a company that values patient access, healthcare education, and strategic reimbursement support . If the FRM position sounds like something you would be interested ... escalations, and appeals. + Deliver payer insights and education on Medicare and commercial insurance coverage. + Collaborate with physician offices, specialty… more
- CVS Health (Austin, TX)
- …day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This role plays a critical part in ... ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of...and internal policies and procedures. + Proven ability to support coding judgment and decisions using industry standard evidence… more