- Humana (Austin, TX)
- …The focus of this role is Medicare Pharmacy and Part D. The Senior Compliance Professional will analyze business requirements, provide research and ... caring community and help us put health first** The Senior Compliance Professional ensures ...Compliance or Health Plan Operations + Familiarity with Medicare pharmacy laws or regulations **Additional Information** Interview Format… more
- Humana (Austin, TX)
- …evaluation of variable factors. We are looking for an experienced Senior Compliance Professional specializing in Medicare Advantage to join our Field ... community and help us put health first** The IFG Senior Compliance Professional ensures ...cross-functional teams, including marketing, operations, and sales, to ensure compliance is integrated into all aspects of Medicare… more
- CenterWell (Austin, TX)
- …part of our caring community and help us put health first** The Senior Strategy Advancement Professional provides data-based strategic direction to identify and ... for business segments or the company at large. The Senior Strategy Advancement Professional work assignments involve...will be responsible for supporting the CenterWell ACO and Medicare payment model programs via the Center for … more
- Humana (Austin, TX)
- …between Humana and its trading partners, Medicare and Medicaid. The Senior Encounter Data Management Professional will work with department leadership, ... caring community and help us put health first** The Senior Encounter Data Management Professional develops business...Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools… more
- Prime Therapeutics (Austin, TX)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** Job Description The ... Senior Compliance Analyst assists in the implementation...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- Prime Therapeutics (Austin, TX)
- …focus **Reporting Structure** + Reports to Sr Professional , Manager, Director or Senior Director in the Compliance department Potential pay for this position ... and drives every decision we make. **Job Posting Title** Senior Compliance Analyst (Interpretation and Advising) -...and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) + Certified Project Management… more
- Prime Therapeutics (Austin, TX)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Compliance Analyst - Remote **Job Description** The Senior ... Compliance and Ethics Professional (CCEP) or Certified Healthcare Compliance Professional (CHC) Certified Project Management Professional (PMP)… more
- Humana (Austin, TX)
- …adjustment coding and documentation accuracy. The Clinical Support Team is seeking a senior professional who will be accountable for developing and maintaining ... caring community and help us put health first** The Senior Market Consultation/Partnership Professional interprets, analyzes, and...+ Help ensure accurate review of medical records for Medicare and Medicaid Risk Adjustment + Review and respond… more
- Houston Methodist (Houston, TX)
- …Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and third-party payments and internal policies. ... as subject matter expert, performing complex and high risk-based and baseline compliance reviews and identifying potential risk areas and revenue potential. The Sr… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Senior Vendor Management Professional works as liaison between vendors and organization. The ... Senior Vendor Management Professional 's work assignments involve...liaison between vendors, internal business owners, contracting, risk, and compliance teams. As part of the Humana Military Contract… more
- CenterWell (Austin, TX)
- …and inspired to help make that happen. Conviva has a strong emphasis on senior -focused primary care for members of Medicare Advantage health plans and is ... both patients and community members improve their health. The Senior Broker Engagement Professional - Care Delivery develops...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Senior Contract Management Professional evaluates, drafts, and negotiates contracts and other ... of goods and services for Humana, its subsidiaries and affiliates. The Senior Contract Management Professional work assignments involve moderately complex to… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Senior Learning Design Professional uses instructional design, cognitive psychology and adult ... to determine the appropriate solution to a knowledge or performance gap. The Senior Learning Design Professional work assignments involve moderately complex to… more
- Providence (TX)
- …are not simply valued - they're invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused, whole-person care ... operates a self-administered claims program for General and Healthcare Professional Liability, Directors and Officers, Employment Practices, Fiduciary, Property,… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Senior Behavioral Economics Professional (SBEP) is a core member of Humana's industry-leading ... The team's work directly informs business decisions and influences broader strategies. The Senior Behavioral Economics Professional (SBEP) is a core member of… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of ... data requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis… more
- NTT America, Inc. (Plano, TX)
- …of written recommendations and interpretations of records. + Prepare reports for senior management on appeal trends and compliance status. **Requirements:** + ... organization, apply now. We are currently seeking a Delivery Senior Manager to join our team. NTT DATA is...our team. NTT DATA is seeking to hire a ** Medicare Appeals Clinical Leader** to lead service delivery engagements… more
- Gentiva (Lubbock, TX)
- **Overview** We're looking for a **Patient Care Manager Senior ** to join our team. You will report directly to the Executive Director or Administrator. You will be ... developing associates and ensuring adherence to company policies and procedures and compliance with local, state, and federal regulations and regulatory agencies. +… more
- WTW (Richardson, TX)
- …leading direct-to-consumer insurance services business, specializing in the distribution of Medicare Advantage, Medicare Supplement and Life & Supplemental ... We are currently seeking a highly motivated and skilled professional to join our Sales Center team as a...a critical role in coaching for continuous improvement, ensuring compliance with quality standards, and creating a high-performance culture… more
- CenterWell (Austin, TX)
- …put health first** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist Therapeutic Subject Matter Expert monitors drug development ... factors. **Responsibilities** The Clinical Drug Evaluation and Policy Strategies Senior Clinical Pharmacist develops, maintains, and/or operationalizes strategies related… more