- Humana (Austin, TX)
- …our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Medicare (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business ... Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies. The business needs of the team… more
- Molina Healthcare (Austin, TX)
- …* Working experience with, and strong knowledge of, various managed healthcare provider compensation and VBP methodologies, primarily across Medicaid and ... live in Georgia _** **Job Description** **Job Summary** Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development… more
- Humana (Austin, TX)
- … Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements. The Provider ... years of experience servicing or negotiating managed care contracts with physician, hospital and/or other provider contracts + Proficiency in analyzing,… more
- Humana (Austin, TX)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the… more
- Molina Healthcare (Austin, TX)
- …experience in Managed Care + 5 or more years hospital reimbursement methodologies + Background in provider contracts, pricing configuration, claim ... The Lead Analyst, Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately. Supports existing lines… more
- Cardinal Health (Austin, TX)
- …Managed Care oversees the interactions that take place between payer and provider (s) to ensure optimal reimbursement including managed care contracting, ... Functions:** + Responsible for documenting and tracking all credentialing, re-credentialing, provider enrollment, and hospital privileging activities within the… more
- Baylor Scott & White Health (Pflugerville, TX)
- …credentialed and privileged, and whose service is billed as an independent billing provider , as recognized by Medicare and Medicaid within the healthcare ... conduct hospital rounds, assist with admissions and discharges, and provide on-call support. **KEY SUCCESS FACTORS** + Knowledge of information and techniques… more
- Option Care Health (Austin, TX)
- …as indicated by location and service line including governmental payers (ie, Medicare, Medicaid ). + Provider NPI will be credentialed in association with the ... Careers. Endless Possibilities.** **With the nation's largest home infusion provider , there is no limit to the growth of...and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a… more
- Baylor Scott & White Health (Pflugerville, TX)
- …Summary** The Nurse Practitioner (NP) Urgent Care is a licensed, certified healthcare provider . They provide direct patient care and have prescriptive authority. ... shifts + Duties: Outpatient clinic care only - no hospital rounding or surgical duties + Experience Preferred: Seeking...They are credentialed, privileged, and billed as an independent provider by Medicare and Medicaid . The Advanced… more
- Baylor Scott & White Health (Austin, TX)
- …**Job Summary** The PA Surgical Specialty-Operative is a licensed, certified healthcare provider . They provide direct patient care and have prescriptive ... plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1 _Note: Benefits...They are credentialed, privileged, and billed as an independent provider by Medicare and Medicaid . The Advanced… more
- Baylor Scott & White Health (Round Rock, TX)
- …The Nurse Practitioner Medical Specialty is a licensed, certified, non-physician healthcare provider . They provide direct patient care and have prescriptive ... They are credentialed, privileged, and billed as independent providers by Medicare and Medicaid . The Advanced Practice Provider offers medical care based on the… more
- Baylor Scott & White Health (Round Rock, TX)
- …The Physician Assistant Medical Specialty is a licensed, certified, non-physician healthcare provider . They provide direct patient care and have prescriptive ... They are credentialed, privileged, and billed as independent providers by Medicare and Medicaid . The Advanced Practice Provider offers medical care based on the… more
- Humana (Austin, TX)
- …coding auditor to review inpatient hospital claims for proper reimbursement , handle provider disputes in a result-oriented and metrics-driven environment. ... Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims… more
- Molina Healthcare (Austin, TX)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Centene Corporation (Austin, TX)
- …on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, ... and personal assistance/social services, and providing patient advocacy and education to Medicaid members * Experience in FIELD-BASED Social Worker or Case Managers… more