- CVS Health (Austin, TX)
- …optimize client engagement and profitability by developing pricing offers that support client retention and growth. Daily activities include monitoring financial ... and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid, Medicare Part D, and Public Exchange lines of business. + Conduct market… more
- CVS Health (Austin, TX)
- …medical costs and provides an unmatched experience for adults on Medicare in medically underserved communities. By providing holistic, comprehensive and integrated ... the industry-leading clinical operations and population health platform to support the delivery of high quality care to the... the delivery of high quality care to the Medicare population. As a Senior Product Manager within the… more
- Actalent (Texas City, TX)
- …determination. Responsibilities + Process and manage denied prior authorization requests for Medicare and Medicaid patients. + Make 30-60 outbound calls per shift to ... Medicare members, primarily elderly individuals, regarding denied medication requests....+ Review submitted documentation and gather additional information to support the appeals process. + Forward completed cases to… more
- Kelsey-Seybold Clinic (Webster, TX)
- …calls regarding admissions to the assigned hospital. + The hospitalists have the support from the critical care physicians and subspecialists. + There is no ... and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with… more
- Evolent (Austin, TX)
- …to the Utilization Management process, interpretation, guidelines and/or system support . + Participates in on-going training per inter-rater reliability process. ... by any state or federal health care program, including Medicare or Medicaid, and is not identified as an...General Service Administration (GSA), or reprimanded or sanctioned by Medicare . + No history of a major disciplinary or… more
- Elevance Health (Denison, TX)
- …week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.… more
- Zelis (Plano, TX)
- …Medicaid billing, reimbursement, claim payment or cost reporting. + Experience with Medicare / Medicare Advantage or commercial billing and reimbursement a plus ... experiences and are committed to building an inclusive workplace for all. Accessibility Support We are dedicated to ensuring our application process is accessible to… more
- Humana (Austin, TX)
- …in dental benefits industry issues preferred o Knowledge and experience in Medicare and Medicaid dental programs preferred **Additional Information** o The Dental ... its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage… more
- Kelsey-Seybold Clinic (Houston, TX)
- …work after hours and on weekends, and also have the opportunity to support the Kelsey-Seybold Clinic by practicing virtual medicine. Per Diem Internal Medicine ... and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with… more
- Kelsey-Seybold Clinic (Houston, TX)
- …and pelvic disorders, and hormonal imbalances. Our specialists also guide and support women throughout their pregnancy in the hospital setting. **Essential Duties ... and is in-network with major insurance plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with… more