- Molina Healthcare (Austin, 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 (Austin, 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 (Austin, TX)
- …**Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function ... as Medicare subject matter expert and point of contact for...drive compliance and performance objectives as well as provide oversight , including service level agreements. + Works with staff… more
- CVS Health (Austin, TX)
- …heart, each and every day. **Position Summary** Drive growth for Medicare Advantage External Distribution Partnerships by setting strategic sales goals, crafting ... achieve measurable results. Act as Chief of Staff to the Executive Director of National External Distribution, ensuring alignment and execution of strategic… more
- Molina Healthcare (Austin, TX)
- …on increased responsibility and adding value to the organization + Ensures strong operational processes are in place to deliver across all areas of responsibility + ... Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. + Manage multiple resources and projects… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Director , Provider Education develops and leads initiatives, strategies, and processes focused on ... enhancing provider knowledge of Medicare and Medicaid quality and risk-adjustment programs. They help...working in close collaboration with regional market teams. The Director , Provider Education is a key leader on the… more
- CenterWell (Austin, TX)
- …improvement. + Work collaboratively with the Strategy Advancement and Operations Director to align clinical and operational priorities. **Quality Improvement ... and help us put health first** The National Medical Director for Home-Based Care Programs is a key clinical...skills; ability to collaborate effectively with clinicians, executives, and operational leaders. + Advanced knowledge of Medicare … more
- Prime Therapeutics (Austin, TX)
- …passion and drives every decision we make. **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account Director is ... As the primary point of contact for their designated BCBS clients, the director promotes and recommends Prime standard offerings to meet client requirements and… more
- Molina Healthcare (Austin, TX)
- …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… more
- Baylor Scott & White Health (Austin, TX)
- …, Denial Resource Center is responsible for the strategic planning, evaluation, and operational oversight of the clinical denial management function for Baylor ... Scott and White Health (BSWH). The Director , Denial Resource Center will lead a highly skilled...function for BSWH. + Recommends and implements strategic and operational plans and priorities for clinical denial management aligned… more
- Molina Healthcare (Austin, TX)
- …Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of processes that track, evaluate, and submit encounter deletions ... for Medicare Advantage, ACA, and Medicaid lines of business. This...accuracy & completeness (ie, Encounter Production, Audit, Production Vendor Oversight ) for assigned lines of business. Responsible for increasing… more