- Humana (Austin, TX)
- …ensure successful submission and reconciliation of encounter submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards ... and develops tools to enhance the encounter acceptance rate by Medicaid/ Medicare . Looks for long term improvements of encounter submission processes. Understands… more
- CenterWell (Alice, TX)
- …two to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... coordinated care environment in a value based relationship environment + Medicare Provider Number / Medicaid Provider Number + Knowledge of Medicare guidelines… more
- Molina Healthcare (Austin, TX)
- …for all staff to follow + Provides monthly reporting to management in support of functional processes + Oversees maintenance of processes and procedures for ... needed + Primary point of contact for the internal partners, ie Medicare Administration, Compliance and Health Plan Operations. Coordinates and facilitates meetings… more
- Prime Therapeutics (Austin, TX)
- …Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid) + Other duties as assigned **Education & Experience** + ... Management organization, or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) + Must be eligible… more
- CVS Health (Richardson, TX)
- …Manufacturer Rebates you will perform a critical role in the analysis of Medicare and Commercial formularies to determine client eligibility for rebates with respect ... to manufacturer contractual guidelines. To support accurate rebate invoicing, you will be responsible for...an emphasis on the RxClaim adjudication platform beneficial. + Medicare knowledge beneficial. + Ability to work independently and… more
- Highmark Health (Austin, TX)
- …collaborates with various teams within data analytics and infrastructure to support the creation, optimization, and maintenance of self-service resources for ... value-based reimbursement programs and continuous improvement models. Lead or support key strategic initiatives across Enterprise and Markets and Provider… more
- HCA Healthcare (Austin, 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
- Humana (Austin, TX)
- …Server to automate and streamline data processes. Your work will directly support strategic decision-making and reduce manual efforts across the organization. **Key ... and reports by integrating data from multiple database sources to support business decision-making. + **Requirements Gathering & Analysis** : Collaborate with… more
- J&J Family of Companies (Dallas, TX)
- …- shaped by personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, ... government payers, etc.) for core and launch products. + Collaborate with field support team members such as sales representatives and key account managers and serve… more
- J&J Family of Companies (Dallas, TX)
- …- shaped by personal experiences and beliefs, the presence or absence of support networks, provider and payer dynamics, and socioeconomic factors. For many patients, ... government payers, etc.) for core and launch products. . Collaborate with field support team members such as sales representatives and key account managers and serve… more