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Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
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An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers. Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance.
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Compliance oversight for "Schedule A" request from carriers, Form 5500, Medicare Part D Disclosures and CMS Reporting, HIPAA and ERISA and COBRA. Compliance oversight for "Schedule A" request from carriers, Form 5500, Medicare Part D Disclosures and CMS Reporting, HIPAA and ERISA and COBRA.
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Works closely with the Quality Manager to ensure compliance with statutory mandates, regulatory requirements and accreditation standards of professional organizations such as JCAHO. (Statutory and regulatory requirements include but are not limited to the following: FDA, OSHA, EPA, EMTALA, Medicare and Medicaid provisions of the Social Security Act.
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Here at Ben E. Keith, we recognize that our workforce reflects the increasingly diverse nature of our society, and we want to do all we can to take advantage of that diversity with both our external and internal customers.
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The actuary will be a key person on the Accountable Care team that analyzes various sources of patient health and claims data to help the business understand, forecast and manage the risk position of various value-based products (MSSP, ACO REACH, Medicare Advantage.
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An Enrollment Specialist is a member of the Patient Engagement Specialist (PES) team, telephonically educating and enrolling patients in a Medicare-sponsored care coordination program designed to help the patient better manage their chronic illnesses (diabetes, high blood pressure, COPD, etc.
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Advantage Pro Services is Houston's leading provider of pressure washing, window cleaning and gutter cleaning services. Advantage Pro Services is Houston's leading provider of pressure washing, window cleaning and gutter cleaning services.
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Proven experience with enterprise-scale technical delivery experience with AI Services including OpenAI, Schematic Kernel, AWS Bedrock, Machine Learning (or equivalent), Generative AI, LLM customization, NLP, Search, MLOps, Open-source AI frameworks, AI Infrastructure, architecture designAbility to align AI/ML initiatives with broader business goals and outcomes, understanding how AI can drive value and competitive advantage.
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We offer care management programs for asthma, diabetes, and high-risk pregnancy. Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR.
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Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
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Our primary care physicians are true hands-on caregivers, transforming the health and lives of seniors on Medicare Advantage. Through our Value Based Care approach, you and your patients thrive in our high-touch, relationship-centered model something the traditional, Fee For Service healthcare model cannot provide.
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The CCO has responsibility for strategic planning and operational leadership pertaining to compliance and regulatory issues as well as oversight of the enterprise wide comprehensive compliance program that includes STAR, CHIP, Marketplace, DSNP, and Medicare Programs that exceed the regulatory agencies requirements.
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The mission of Oxy Low Carbon Ventures, LLC (OLCV) is to extend Occidental’s distinct competitive advantage in carbon capture, utilization, and storage (CCUS) and to explore other low carbon opportunities.
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Experience maintaining cell lines in tissue culture, experience with microscopy and imaging will be a great advantage. Education Doctoral degree in Pharmacology, Biology, Chemistry, Biochemistry, Molecular Biology, Cell Biology, Enzymology, or related biomedical science-related field with experience in pharmaceutical research laboratory.
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medicare advantage jobs Company: Guidehouse in Houston, TX
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