- Texas Health and Human Services Commission (Austin, TX)
- …Description: The Financial Examiner III reports to the Quality Review Manager in the Provider Finance Department (PFD). Performs moderately complex (journey-level) ... as conducting examinations to determine and report on financial conditions and compliance with statutory requirements, bylaws, and regulations. The role works under… more
- IDEA Public Schools (Austin, TX)
- …on a weekly/bi-weekly basis. Submit Therapy Logs on a Quarterly Basis to their Manager . Maintain SHARS ( Medicaid ) records and submit SHARS documentation on a ... update goals and request additional testing when deemed necessary. Ensure 100% compliance by completing Occupational Therapy Initials and Re-Evaluations prior to due… more
- Sumitomo Pharma (Austin, TX)
- …dynamic, highly motivated, and experienced individual for the position of Sr. Manager , Medicaid Contract Administration. This position is responsible for ... managing the Medicaid rebate team in receiving, processing, validating, trouble-shooting ...with internal departments (Internal Audit, Commercial Insights, Contracting, SOX Compliance , and Legal) to clarify policy compliance … more
- Molina Healthcare (Austin, TX)
- …with other Core Ops areas of responsibilities) within Medicare and Medicaid . Role is predicated on building relationships with vendors, stakeholders, functional ... vendor performance involving onshore and offshore resources, monitors regulatory compliance adherence (in conjunction with functional counterparts) and quality… 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
- 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
- Molina Healthcare (Austin, TX)
- …integration, and a strong understanding of data governance and compliance in healthcare environments. **Knowledge/Skills/Abilities:** * Architect and implement ... Deploy, monitor, and troubleshoot Hadoop-based infrastructure using tools such as Cloudera Manager , Ambari, and Zookeeper. * Enforce data quality, security, 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
- Molina Healthcare (Austin, TX)
- **Job Summary:** The Subrogation Manager is responsible for overseeing all aspects of healthcare subrogation operations across Medicaid , Medicare, and ... protocols to support efficient and compliant subrogation operations across Medicaid , Medicare, and Marketplace populations. + Collaborate with legal, claims,… 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
- Molina Healthcare (Austin, TX)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Relations ... and implements tracking tools to ensure timely issue resolution and compliance with all applicable standards. * Oversees appropriate and timely… more
- Molina Healthcare (Austin, TX)
- …intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid ). Executes health plan's member and community quality focused interventions ... to identify opportunities for improvement + Surfaces to the Manager and Director any gaps in processes that may...+ 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting, analysis,… 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
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Manager , Technology Solutions devises an effective strategy for executing and delivering on IT ... business initiatives. The Manager , We are seeking a highly skilled and motivated...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Wolters Kluwer (Austin, TX)
- …information and policy data sources (CMS, FDA, etc.) covering drug control/ compliance programs, covered programs (Medicare/ Medicaid ) and other government ... **Lead Technology Product Manager ** - Commercial Drug Information This role follows...**Wolters Kluwer Health team** , the **Lead Technology Product Manager for Medi-Span** plays a critical role in advancing… more
- Molina Healthcare (Austin, TX)
- …Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Negotiates agreements ... Tighter knit proximity ongoing after contract. * In conjunction with Director/ Manager , Provider Contracts, negotiates Complex Provider contracts including but not… more
- Centene Corporation (Austin, TX)
- …End-to-end development, filing and execution of the Medicare Supplemental benefits. Program Manager III will own a complex portfolio of designs, and directly ... annually. Directly responsible for developing CMS filing guides for benefits. Program Manager III is responsible for development, aspects of contract and rate… more
- Molina Healthcare (Austin, TX)
- …position requires a current South Carolina pharmacist license **Job Summary** The Pharmacy Manager , Health Plan Pharmacy Services is an integral role of the Health ... the team in understanding pharmacy quality, cost effectiveness and compliance and working closely with the Pharmacy Director or...good standing. + Must be free of sanctions from Medicaid or any other government program and without restrictions… more
- Humana (Austin, TX)
- …help us put health first** Humana's Marketing organization is seeking a Senior Product Manager who specializes in Next Best Action (NBA) execution to join the team ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Austin, TX)
- …us put health first** We're seeking a strategic, results-driven Lead Product Manager to design and deliver innovative clinical solutions that improve health outcomes ... a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
