- Molina Healthcare (Fort Worth, TX)
- …operation process designs and establishes procedures and techniques for operational standards. Confers with customers to define and resolve ... **Knowledge/Skills/Abilities** Responsible for the oversight of regulatory compliance of Corporate Operations functions, including but not limited to performance of… more
- Molina Healthcare (Fort Worth, TX)
- …compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and ... related field (advanced degree a plus). **Experience** * 7+ years managing Medicare CTM, appeals & grievances, or related compliance functions-hands-on with CMS CTM… more
- Molina Healthcare (Houston, TX)
- …and regulations, contract provisions, and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general ... reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan,… more
- Molina Healthcare (TX)
- …and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's ... for leading, organizing and directing the activities of the Medicare Duals Grievance and Appeals Unit that is responsible...DSNP, HIDE, FIDE, EAE, AIP, etc. * Provides direct oversight , monitoring and training of provider disputes and appeals… more
- Centene Corporation (Austin, TX)
- …and laws related to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of business, which includes implementation of elements of an effective ... compliance program. Oversee the development of risk assessments oversight and the monitoring work plans pertaining to Risk Adjustment. Partners with business areas… more
- Humana (Austin, TX)
- …our caring community and help us put health first** The Associate Director , Compliance ensures compliance with governmental requirements. The Associate Director , ... required to work in either Central or Eastern Time. Associate Director , Regulatory Intake Compliance is responsible for enterprise-wide regulatory monitoring,… more
- Jet Health (Fort Worth, TX)
- …our team. The Director of Clinical Services is aregistered nursewho provides oversight of all patient care services and personnel for ourFort Worth, Garland and ... Director of Clinical Services - Home Health Fort...and regulatory fulfillment of timely documentation. + Compliance:Focus on Medicare Quality Measures and other industry standards to ensure… more
- Molina Healthcare (Houston, TX)
- …expert and leads programs to meet critical Quality needs. + Manages QI programs with oversight from the Director , AVP and VP as needed. + Collaborates and ... + 2 years Medicare experience + 3 years management experience + Operational knowledge and experience with Excel and Visio (flow chart equivalent). + Proficiency… more
- Molina Healthcare (Houston, TX)
- …between Molina Healthcare and contracted provider network. In partnership with Director , manages and coordinates the Provider Services activities for the state ... for the daily operations of the department working collaboratively with other operational departments and functional business unit stakeholders to lead or support… more
- HCA Healthcare (Houston, TX)
- …want to join an organization that invests in you as a Texas Regional Director Emergency Management and Business Continuity? At HCA Healthcare, you come first. HCA ... opportunity to make a difference. We are looking for a dedicated Texas Regional Director Emergency Management and Business Continuity like you to be a part of our… more
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