- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Sr. Medicare (PPS) Provider Hospital Reimbursement Analyst will be an integral part of the ... of the team as it expands to accommodate the increased responsibilities. The Provider Hospital Reimbursement Analyst r will be primarily responsible… more
- Humana (Austin, TX)
- …2 who initiates, negotiates, and executes physician, hospital , and other provider contracts and agreements related to Medicaid health plans. The ... and independent determination of the appropriate courses of action. The Provider Contracting Professional 2 responsibilities include (but not limited to): +… more
- Humana (Austin, TX)
- …Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital , and/or other provider contracts and agreements for an ... organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the… more
- Molina Healthcare (Austin, TX)
- …experience in Managed Care + 5 or more years hospital reimbursement methodologies + Background in provider contracts, pricing configuration, claim ... The Lead Analyst, Reimbursement is responsible for administering complex provider reimbursement methodologies timely and accurately. Supports existing lines… more
- Abbott (Austin, TX)
- …policies (Medicare, Medicare Advantage, Medicaid and Private Payer) to provide coverage and reimbursement guidance for Investigational Device Exemption ... processes and other related matters requiring a specialized knowledge of Medicare, Medicaid and Private Payer reimbursement procedures and requirements. + Heavy… more
- Centene Corporation (Austin, TX)
- …cross functional teams in the management of multiple VBP relationships including Provider Groups (IPAs) and the other contracting entities like ACOs and potentially ... the New York State Department of Health and Center for Medicare and Medicaid Services' Value Based Payment programming. Support exploration of additional VBP models… more
- Baylor Scott & White Health (Round Rock, TX)
- …credentialed and privileged, and whose service is billed as an independent billing provider , as recognized by Medicare and Medicaid within the healthcare ... of the provider ) as delegated by supervising Physician. May conduct hospital rounds, assist with admissions and discharges, and provide on-call support.… more
- Baylor Scott & White Health (Pflugerville, TX)
- …credentialed and privileged, and whose service is billed as an independent billing provider , as recognized by Medicare and Medicaid within the healthcare ... conduct hospital rounds, assist with admissions and discharges, and provide on-call support. **KEY SUCCESS FACTORS** + Knowledge of information and techniques… more
- CenterWell (Austin, TX)
- …experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + ... degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or... Experience a plus + Current nursing experience in Hospital , SNF, LTAC, DME or Home Health. + Bilingual… more
- Baylor Scott & White Health (Pflugerville, TX)
- …Summary** The Nurse Practitioner (NP) Urgent Care is a licensed, certified healthcare provider . They provide direct patient care and have prescriptive authority. ... shifts + Duties: Outpatient clinic care only - no hospital rounding or surgical duties + Experience Preferred: Seeking...They are credentialed, privileged, and billed as an independent provider by Medicare and Medicaid . The Advanced… more
- Baylor Scott & White Health (Austin, TX)
- …**Job Summary** The PA Surgical Specialty-Operative is a licensed, certified healthcare provider . They provide direct patient care and have prescriptive ... plan with dollar-for-dollar match up to 5% + Tuition Reimbursement + PTO accrual beginning Day 1 _Note: Benefits...They are credentialed, privileged, and billed as an independent provider by Medicare and Medicaid . The Advanced… more
- Molina Healthcare (Austin, TX)
- …modeling current and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. * Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Austin, TX)
- …modeling current and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of ... Business Intelligence tools (Medinsight, PowerBI), and Executive Dashboard. + Generate hospital performance analytics tools on a quarterly basis; develop reports on… more
- Molina Healthcare (Austin, TX)
- …(UB04/1500 form). * Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS ... from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions… more
- Centene Corporation (Austin, TX)
- …on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, ... and personal assistance/social services, and providing patient advocacy and education to Medicaid members * Experience in FIELD-BASED Social Worker or Case Managers… more
- HCA Healthcare (Austin, TX)
- …spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal ... for our team to ensure that we continue to provide all patients with high quality, efficient care. Did...and self-pay accounts to enhance cash flow and gather reimbursement based on established contracts. **What you will do… more
- Ascension Health (Austin, TX)
- …CEE + **Schedule:** Monday - Friday, 8:00 am - 4:30 pm + ** Hospital :** Seton Administrative Offices + **Location:** Austin, TX (Onsite) **Benefits** Paid time off ... disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community _Benefit options and… more