- 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
- 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)
- …efforts that enhance both provider and patient experience. **Governance & Delegation Oversight ** The Clinical Director will participate in governance committees ... part of our caring community and help us put health first** The Clinical Director is a key member of the regional clinical leadership team responsible for executing… more
- The Cigna Group (Plano, TX)
- **Job Description: Director for Regulated Markets - CDAG/ODAG** **Excited to grow your career?** We value our talented employees, and whenever possible strive to ... the difference in our success. **Role Summary** : The Director of Regulated Markets is responsible for Coverage Review...Markets is responsible for Coverage Review and Determinations for Medicare Part B and Part D, Medicaid, Marketplace or… 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
- CenterWell (Austin, TX)
- …and communicate remediation plan to IPA Dyad partners. + Partners with market operational leaders to identify operational issues that impact clinician and coder ... staff workload and redistribute resources as needed to meet market operational demands. + Monitor coding processes, identify inefficiency, and develop… more
- CenterWell (Austin, TX)
- …Director , the Senior Strategy Advancement Professional will bring a combination of operational support, analyst skills, and strategy oversight to the role. ... (ACO) business. This role will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for Medicare and Medicaid… more
- Fresenius Medical Center (Plano, TX)
- …key member of the Revenue Cycle leadership team this role will have direct oversight and responsibility for all processes related to the front-end services of the ... Managed Care and Insurance Coordinators. The VP of Revenue Cycle will have oversight that encompasses associates domestically and with our global partners to partner… 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
- Molina Healthcare (Houston, TX)
- …in collaboration with the Manager or Director . * Keeps Manager or Director apprised of operational issues, including staffing resources, program and system ... drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient… more
- Fresenius Medical Center (Olmito, TX)
- …is responsible to the ASC Governing Body for clinical reporting and for operational oversight . PRINCIPAL DUTIES AND RESPONSIBILITIES: **Environment of Care & ... responsible for the leadership of the clinical facility ensuring all clinical, operational , and business objectives are met. The Facility Administrator is authorized… more
- HCA Healthcare (Pearland, TX)
- …to focus on bedside care, a leadership or C-suite role, shape business and operational outcomes, or work to deliver clinical excellence behind the scenes in data ... well as support activities related to classroom coordination, registration oversight , documentation of participation, scheduling, and procurement of teaching… more