- Highmark Health (Austin, TX)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Austin, TX)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Prime Therapeutics (Austin, TX)
- …Posting Title** Manager , Compliance - Remote **Job Description** The Compliance Manager works closely with designated business areas, Legal, and other ... Expertise in their areas of focus (Affordable Care Act, Medicare, Medicaid , Corporate Compliance , Compliance Assessment or Services etc.) + Develop and… more
- CVS Health (Austin, TX)
- …problem-solving abilities **Preferred Qualifications** Clinical Coding Experience - Content Manager Claim Processing Medicaid Working with SQL Application ... and every day. Remote: can work anywhere in the US **Position Summary** Medicaid Claim Editing Content Management team. Must oversee ongoing content delivery and… more
- Prime Therapeutics (Austin, TX)
- … with federal laws, state laws and standards of practice which govern the Medicaid Drug Rebate Program. + Ensures compliance with each State Medicaid ... passion and drives every decision we make. **Job Posting Title** Manager Rebate Pharmacy Operations **Job Description Summary** This position provides administrative… more
- Abbott (Austin, TX)
- …and scalability, ensuring support for long-term business growth. + Ensure strict compliance with Medicaid , Medicare, and other relevant regulatory programs, and ... Alpharetta, GA)** is looking for a **Contract Strategy & Business Engagement Manager ** **.** This person will spearhead the development, execution, and optimization… more
- Humana (Austin, TX)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Prime Therapeutics (Austin, TX)
- …our passion and drives every decision we make. **Job Posting Title** Client Quality Manager Stars and Quality - Remote **Job Description** The Senior Client Quality ... Manager ensures the successful planning, implementation and execution of...provides leadership and subject matter expertise on Medicare Stars, Medicaid quality and the Commercial/Health Insurance Marketplace Quality Rating… more
- Prime Therapeutics (Austin, TX)
- …and ability to adjust focus **Reporting Structure** + Reports to Sr Professional, Manager , Director or Senior Director in the Compliance department Potential pay ... our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) - Remote **Job Description** The Senior … more
- Molina Healthcare (Austin, TX)
- …contractual requirements related to government programs including, but not limited to, Medicaid , duals (MMP) and Marketplace. * Serves as primary internal contact ... interpretations. * Monitors daily Government Contracts activities to ensure contractual compliance with state and federal requirements for all lines of business… more
- HCA Healthcare (Austin, TX)
- …opportunity to make a real impact. As a(an) Registered Nurse Coordinator Regulatory Compliance you can be a part of change. **Benefits** St. David's Surgical ... outcomes for your patients as a (an) Registered Nurse Coordinator Regulatory Compliance . We want your knowledge and expertise! **Job Summary and Qualifications**… more
- Caris Life Sciences (Austin, TX)
- …bigger than yourself, Caris is where your impact begins.** **Position Summary** The Manager of Clinical Payor & Policy Relations will be responsible for research and ... of healthcare delivery systems, specifically commercial and government-sponsored programs such as Medicaid and Medicare, and roles of key stakeholders. + Ability to… more
- Humana (Austin, TX)
- …of Case Management team on cases with support needs. Ensures regulatory compliance by aligning care management policies, procedures, and processes to maintain ... initiatives to maintain focus on performance goals and standards, quality and compliance measures with development of action plans to improve results. + Ensures… more
- Humana (Austin, TX)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… more
- Prime Therapeutics (Austin, TX)
- …management in the areas of problem identification and resolution, process improvements, compliance with Centers for Medicare & Medicaid Services (CMS) ... passion and drives every decision we make. **Job Posting Title** Vendor Program Manager Senior **Job Description** The Vendor Program Manager is responsible for… more
- HCA Healthcare (Georgetown, TX)
- …We care like family! Jump-start your career as a Patient Access Manager today with St. David's Georgetown Hospital. **Benefits** St. David's Georgetown Hospital, ... for benefits may vary by location._** Come join our team as a Patient Access Manager . We care for our community! Just last year, HCA Healthcare and our colleagues… more
- Datavant (Austin, TX)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- Cognizant (Austin, TX)
- **Credentialing Account Manager (remote)** **This is a remote position open to any qualified applicant in the United States.** **Summary:** The Credentialing Account ... Manager oversees the end-to-end credentialing process for healthcare providers,...coordinates with internal teams to resolve issues and maintain compliance . **Key Responsibilities:** + Act as the primary liaison… more
- Molina Healthcare (Austin, TX)
- …needs, support to other business units + Strong business knowledge related to Medicaid and Medicare lines of business + Reviews enrollment issue trends and provides ... + Ensures compliant with regulatory and company guidelines, including HIPAA compliance + This position primarily focuses on project/program management related to… more
- Amazon (Austin, TX)
- …in PBM, health insurance, pharmacy, business development, marketing, managed care, Medicaid , Medicare Part D, and commercial innovation. - Bachelor's degree in ... including Operations, Marketing, Account Services, Tech, Product, Legal, and Compliance . - Demonstrate clear, concise, written and oral communication. Amazon… more