- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted ... initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from the physician… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN) responsible for comprehensively planning for case management, which includes care ... care, hospice, and durable medical equipment. Consults with Social Worker Case Manager to assess psychosocial needs associated with transition to alternative levels… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient ... initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from the physician… more
- Molina Healthcare (Fort Worth, TX)
- …with other Core Ops areas of responsibilities) within Medicare and Medicaid . Role is predicated on building relationships with vendors, stakeholders, functional ... Level Agreements between the parties. **Job Duties** + Develops Medicare and Medicaid vendor strategies aligned with CMS and State regulations, including contract… more
- Humana (Austin, TX)
- …community and help us put health first** The Special Investigations Unit Manager leads and monitors investigations of allegations of fraudulent and abusive ... practices. The Manager , Fraud and Waste works within specific guidelines and...communication skills, written and verbal + Strong organizational and project management skills + Strong Analytical skills + Core… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Case Manager (CM) Advanced position is a registered nurse (RN) responsible for promoting the achievement of optimal clinical and resource ... level at all the objectives delineated in the Case Manager and Case Manager Certified job roles...families and works with the leadership team for special project activities related but not limited to, throughput, readmissions,… more
- UTMB Health (Galveston, TX)
- Manager , Coding & QA Clinical - Revenue Cycle Coding **Galveston, Texas, United States** **Hot** Business, Managerial & Finance UTMB Health Requisition # 2504148 ... manages all coding activities related to clinical coding. The Manager of Coding ensures accurate and timely coding of...* Knowledge of federal and state collection laws, Medicare, Medicaid , and other third-party pay or regulatory requirements. *… more
- Datavant (Austin, TX)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Coding Data Integration, you will own the data strategy and ... data. You will also support scalable, reliable, and performant project data ingestion pipelines and maintain databases that support...and management of client data for MA, ACA, and Medicaid plans, ensuring HIPAA and CMS compliance + **Standard… more
- American Heart Association (Dallas, TX)
- …Association has an excellent opportunity for a **Senior** **Healthcare Quality Measures Manager ** based out of our National Center office. This position is ... in monitoring relevant national programs such as the Center for Medicare/ Medicaid Services (CMS): Merit-Based Incentive Payment System (MIPS) and, Hospital Inpatient… more
- Molina Healthcare (TX)
- …and processing. This role will focus on identifying, reviewing, and validating Medicaid secondary payments to ensure alignment with internal configuration rules and ... adjudication, QNXT system navigation, and strong analytical acumen. Experience in Medicaid managed care is required, and a background in payment integrity-either… more