- Molina Healthcare (San Antonio, TX)
- …performance indicators (KPI's) with multiple targets depending on Medicare Program and State requirements. **Job Qualifications** **Required Education** Associate's ... Claim Experience. **Required Experience** * 7 years' experience in healthcare claims review and/or Provider appeals and grievance processing/resolution, including… more
- Molina Healthcare (San Antonio, TX)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + Previous ... Medicare) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare Administration, etc. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Board Certification… more
- Kyndryl (Austin, TX)
- …as a strategic partner. + Bring consulting experience-preferably in the Healthcare space-to tailor engagements that resonate with industry-specific needs and ... new and existing clients by leading Digital Workplace-focused transformation programs , services and implementations centered on Collaboration, Virtualization, Contact… more
- Molina Healthcare (Fort Worth, TX)
- …by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that ... related compliance functions-hands-on with CMS CTM portal, SLA tracking, and program audits. * Deep knowledge of Medicare regulations affecting complaints,… more
- Molina Healthcare (TX)
- …Team. Responsible for the monitoring and intelligence, incident response, and investigations programs which are in place to avoid business disruption, threats to ... the enterprise. + Oversees and delivers tactical, operational 24x7x365 programs for enterprise protection services including physical security, crisis management… more
- Wolters Kluwer (Dallas, TX)
- …in the office (see locations on the posting) **OVERVIEW** The Associate Director , Industry Segment Marketing Programs is responsible for developing Clinical ... the buyer messaging blueprint for use in customer-facing marketing programs + Develop, manage, and measure a program...5 years of experience in healthcare or healthcare IT + Experience managing large scale programs… more
- Molina Healthcare (Fort Worth, TX)
- …delegation oversight committees. * Liaison to Special Investigative Unit regarding program integrity and oversight cost expenditure. * Monitor internal compliance of ... Corporate Operations units via establishment of an internal compliance program , including annual, periodic, focal, etc. audits. * Request, review and perform… more
- Molina Healthcare (Fort Worth, TX)
- …adequacy, financial performance and operational performance, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance ... * Oversees the maintenance of all Provider Contract templates including VBP program templates. Works with Legal and Corporate Network Management as needed to… more
- HCA Healthcare (Houston, TX)
- …team **Incentive/Benefits Package:** + Guaranteed hourly rate + Associate Medical Director Stipend + Holiday pay incentives + Rich benefits package (health, ... weeks gestation + March of Dimes NICU Family Support Program + x4 daVinci robots + Dedicated OB emergency...Intermediate Care Unit + Antepartum Unit + Perinatal Navigation Program + Pediatric Center with ICU and in-house hospitalists… more
- Molina Healthcare (TX)
- …processes are established. Develops and performs internal audits/risk assessments, monitoring program for Molina Healthcare departments. Provides post audit ... standards, and policies and procedures for the Medicare and Dual Eligible Program and participates in the strategic development of its products and services.… more
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