- Molina Healthcare (Houston, 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
- Molina Healthcare (Houston, TX)
- …to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight , monitoring ... and implements process improvements to achieve member/provider satisfaction or operational effectiveness/efficiencies which contribute to Molina Medicare 's… 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
- 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
- Molina Healthcare (Houston, TX)
- …strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core ... contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight . Tighter knit proximity ongoing after contract. * In conjunction… more