- WelbeHealth (Austin, TX)
- …Plan Services team helps ensure excellent care delivery for our participants, and the Claims Audit Analyst plays a pivotal role in ensuring timely and accurate ... At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option...Provide feedback to the Oversight & Monitoring Manager on claims processing errors, quality improvement opportunities, and… more
- CRC Insurance Services, Inc. (Flower Mound, TX)
- …5. Train claims staff on new policies or procedures. 6. Oversee and audit claims process ensuring proper documentation was created in the system and/or ... Coordinators reviewing allocation of staff to ensure productivity and quality standards meet or exceed expected goals. 4. Review,...order to provide account loss ratios and claims history to senior management.… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …actions (CAPAs). + Monitor audit trends and escalate recurring issues to senior leadership. ** Quality Systems & Compliance** + Support the implementation and ... **Job Summary** The Senior Manager of Global Quality Management...standards across global clinical trials. This role provides hands-on quality oversight, supports audit and inspection readiness,… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …leading, and optimizing one or more prioritized CoEs within the Global Quality Operations organization-such as Inspection Readiness, Audit Effectiveness, or ... The Senior Manager, Centers of Excellence (CoEs) is responsible...execution of one or more CoEs (eg, Inspection Readiness, Audit Effectiveness) aligned with global quality priorities.… more
- Molina Healthcare (TX)
- …care data like Medical Claims , Pharmacy, Lab and HEDIS rates. + Assist Quality department with HEDIS measure deep dive to support HEDIS audit and revenue ... **Job Description** **Job Summary** The Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Analytics team. Designs and… more
- Houston Methodist (Bellaire, TX)
- …risk and identify and capture potential revenue opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of ... specific practices. Serves a subject matter expert. + Effectively communicates audit results to faculty and staff. ** QUALITY /SAFETY ESSENTIAL FUNCTIONS**… more
- DXC Technology (Plano, TX)
- …with senior leaders across L&A customers, including Operations, IT, Claims , Actuarial, Distribution, Policy Admin, and Customer Experience. + Conduct regular ... + Ensure all transformation and run-rate services are executed with compliance, audit -readiness, and quality . **Basic Qualifications** + Bachelor's degree in a… more
- Cardinal Health (Austin, TX)
- …in problem-solving, research and problem/dispute resolution. **_Job Summary_** The Senior Coordinator, Prior Authorization is responsible for obtaining, documenting, ... with payers and provider offices to secure timely approvals. The Senior Coordinator proactively manages upcoming expirations to prevent order delays, meets… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Senior Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive ... practices. The Senior Fraud and Waste Professional work assignments involve moderately...ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Begins to influence department's strategy. Makes decisions… more
- HP Inc. (Spring, TX)
- **Job Summary** As the Senior Director of HP's Global Logistics Procurement you will lead the strategy and performance for logistics sourcing including ... sustainable logistics operation worldwide. You will oversee a global team of senior managers leading the sourcing, contracts and freight cost governance. You will… more