- Molina Healthcare (Houston, TX)
- **Job Description** **Job Summary** Establish a specifically designed compliance program that effectively prevents and/or detects violation of applicable laws and ... the Health Care environment. Ensures the Business' accountability for compliance by overseeing, follow-up and resolution of investigations. **Knowledge/Skills/Abilities**… more
- Houston Methodist (Katy, TX)
- …Access Services, and Utilization Review as needed to ensure operational billing compliance with government/regulatory agencies and the Medicare and Medicaid ... At Houston Methodist, the Manager Revenue Cycle position is responsible for the...guidance to staff and is responsible for staffing, budget compliance , contributing to staffing decisions such as hiring and… more
- CVS Health (Austin, TX)
- …care objectives. Working cross-functionally with Duals Center of Excellence, clinical, compliance , analytics and network teams, the Senior Manager drives ... Leads the strategy, design, development and life cycle management of Aetna Medicare products that serve Medicare Advantage populations, including Chronic Care… more
- Molina Healthcare (Fort Worth, TX)
- …Enrollment activities (along with other Core Ops areas of responsibilities) within Medicare and Medicaid. Role is predicated on building relationships with vendors, ... vendor performance involving onshore and offshore resources, monitors regulatory compliance adherence (in conjunction with functional counterparts) and quality… more
- Molina Healthcare (Austin, TX)
- …business areas and owners to ensure processes and reporting exists to demonstrate compliance to regulatory requirements. * Supports Manager and Director with ... to assess, oversee, and recommend business practices to ensure adherence to and compliance with State and Federal regulatory guidelines. The Sr. Analyst develops and… more
- Molina Healthcare (TX)
- …integration, and a strong understanding of data governance and compliance in healthcare environments. **Knowledge/Skills/Abilities:** * Architect and implement ... Deploy, monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, and … more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Manager of Research Billing Compliance position is responsible for managing the development and execution of the Houston Methodist ... Research Institute research billing compliance program to meet all legal and institutional requirements....to those needs is well established and maintained. The manager position responsibilities include managing the daily work activities… more
- Cardinal Health (Austin, TX)
- …of the annual enterprise risk assessment and audit and monitoring plan. The Manager has supervisory responsibility for all Compliance Audit staff. **_What is ... **_What Ethics & Compliance contributes to Cardinal Health_** Ethics & ...facility fee coding and auditing. + Expert-level knowledge of Medicare and Medicaid documentation and coding rules and guidelines;… more
- Centene Corporation (Austin, TX)
- …and leads the identification, implementation, and maintenance of Duals and overlapping Medicare compliance policies, procedures and work instructions. + Leads ... of D-SNP requirements and implementations where needed. + Performs interim Duals Compliance manager responsibilities to include supporting the health plan … more
- UTMB Health (Galveston, TX)
- …government payor reimbursement-related calculations and estimates and ensures UTMB compliance with Medicare and Medicaid regulations. **Scope:** Institutional ... actions to implement appropriate processes and procedures to ensure compliance with Medicare and Medicaid regulations. +...to include four (4) years of reimbursement experience at manager level or above. + Experience with Medicare… more
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