- CVS Health (Austin, TX)
- …data analysis to strategize and achieve operational targets for NCQA HEDIS and Medicare Stars * Provide analysis support for PIP reports to regulators, ... data-driven insights, and enhance the delivery of healthcare services. Provides support in completing regulatory reporting requirements and contributes to the… more
- CenterWell (Austin, TX)
- …Owner to lead the delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D. + Experience with contact center platforms and CRM… more
- CVS Health (Austin, TX)
- …will be responsible for designing, developing, testing and deploying full-stack solutions in support of Aetna's Medicare business. You will work closely with ... Ready to take your Application Development skills to the next level? Aetna Medicare Product Tools & Technology is seeking a Senior Software Development Engineer to… more
- CVS Health (Austin, TX)
- …Network; Examples include ensuring data standards are synchronized across Medicaid and Medicare platforms, ensuring duals workflows are support across systems, ... experience in strategy and delivery leadership roles + 5+ years of Medicare /Medicaid and/or Duals experience + Proven success navigating large scale cross functional… more
- Humana (Austin, TX)
- …necessary to support optimal value based care in accordance with Medicare and Humana policy. The Medical Director will collaborate with clinicians and ... Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical...support optimal value based care in accordance with Medicare and Humana policy. **Use your skills to make… more
- UTMB Health (Galveston, TX)
- …calculations and estimates and ensures UTMB compliance with Medicare and Medicaid regulations. **Scope:** Institutional **Responsibilities:** + Responsible ... for technical aspects, calculations and analyses of multiple areas of Medicare and Medicaid reimbursement components including, but not limited to, cost report… more
- Molina Healthcare (Houston, TX)
- **Job Description** **Job Summary** Provides leadership to the Medicare Duals team and plays a critical role in advancing the Medicare Integrated Duals segment ... strategic priorities. Develops and executes Medicare strategies, including state-specific and product-specific growth initiatives. Leads high-priority projects… more
- Sanford Health (TX)
- …assigned. Manages reporting, auditing, and data exchange of the government programs - Medicare Advantage, ACA, and Medicaid, in support of business objectives. ... for regulated reporting and audit readiness of the Government Program products, including Medicare Advantage, ACA, and Medicaid, to ensure we are meeting all State… more
- Texas Health Resources (Arlington, TX)
- …and achieving payment. + Serves as a liaison and subject matter expert in support of entity leaders and staff to enable and improve operational problem solving ... other programs. + Oversees or supports departments and entities with various Medicare and Medicaid Supplemental Payment and incentive programs including but not… 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