- Zelis (Plano, TX)
- …gained, and the personal interests that shape who you are. Position Overview The Sr . Medicaid Reimbursement Regulatory Analyst will collaborate with ... timely fashion. What you'll do: + Research and decipher regulatory sources such as legislative rules, state registers, waiver...a related field + Five+ years of experience in Medicaid billing, reimbursement , claim payment or cost… more
- Molina Healthcare (Fort Worth, TX)
- … reimbursement models in concert with direct management and senior leadership/management. * Communicates new strategies to corporate provider network leadership ... activities for the state health plan. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider… more
- Baylor Scott & White Health (Dallas, TX)
- **JOB SUMMARY** The Healthcare/Billing Compliance Consultant Sr performs ongoing activities related to the development, implementation, maintenance of, and adherence ... to ensure compliance with BSWH policies and CMS and Texas Medicaid regulations, providing reports, recommendations, and corrective action follow-up. Monitors trends… more
- Centene Corporation (Austin, TX)
- …work remotely anywhere in the Continental United States. **Position Purpose:** Ensure regulatory compliance with federal and state legal and regulatory ... policy concerning federal managed care regulations and initiatives + Represent senior management at various committees, meetings, and seminars + Communicate with… more
- Gentiva (Lubbock, TX)
- …ill patients and their families. + Thorough knowledge of managed care principles, regulatory guidelines (ie, Medicare, Medicaid , JCAHO, ACHC, and human resource) ... **Overview** We're looking for a **Patient Care Manager Senior ** to join our team. You will report...and compliance with local, state, and federal regulations and regulatory agencies. + Preparing for, serving on, and facilitating… more
- Centene Corporation (Austin, TX)
- …with regulations and laws related to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of business, which includes implementation of elements of ... issues and implementation of new compliance requirements with respect to regulatory and contractual language. + Conducts compliance reviews and manages team… more
- CVS Health (Austin, TX)
- …role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager. In this role, you will manage negotiations, conduct high-level reviews ... and the review and analysis of reports as part of negotiation and reimbursement modeling activities. * Responsible for identifying and managing cost issues and… more
- Texas Health Resources (Arlington, TX)
- …safety-net services through various supplemental payment programs. The VP Government Reimbursement Medicaid Payments has the following duties and ... in negotiations with the fiscal intermediary. + Sets annual Medicare and Medicaid reimbursement rates for budget and extended forecasting. Estimates and… more
- Methodist Health System (Dallas, TX)
- …and state laws relating to healthcare, including but not limited to Medicare/ Medicaid reimbursement , HIPAA, AKS, self-referral prohibitions, and fraud and abuse. ... management, health information management, litigation support related to operations and regulatory matters, medical staff services, marketing, and supply chain. This… more
- Abbott (Austin, TX)
- …ensuring support for long-term business growth. + Ensure strict compliance with Medicaid , Medicare, and other relevant regulatory programs, and provide guidance ... retirement savings plan with high employer contribution + Tuition reimbursement , the Freedom 2 Save (https://www.abbott.com/corpnewsroom/strategy-and-strength/tackling-student-debt-for-our-employees.html) student debt program… more
- Houston Methodist (Houston, TX)
- …maintenance and payer relations of the Houston Methodist (HM) contracts for reimbursement of services billed through managed care companies and serves as a ... operations staff of specific HM facility and Physician Organization contracts for reimbursement of services billed through managed care. The managed care payers… more
- Banner Health (TX)
- …records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services ... as appropriate. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding. CORE FUNCTIONS 1. Analyzes… more
- Gentiva (San Antonio, TX)
- …our team. You will report directly to the Executive Director, Administrator, or Senior Patient Care Manager. You will be responsible for maintaining a high ... procedures and compliance with local, state, and federal regulations and regulatory agencies. + Overseeing and managing rescheduled, declined, missed, and reassigned… more