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- ...Summary: The RN Navigator Home Health Review plays a crucial role in monitoring post-acute patients to ensure they continue to meet the CMS criteria for services. As a key member of the patient’s care team, the RN Navigator acts as a patient advocate, providing proactive...CmsFull timeWork at officeMonday to Friday
Christus Health
Irving, TX10 hours ago $200k - $300k
...timekeeping regulations Participates in psychiatry QI/QM program Provides emergency psychiatric call Works effectively with all CMS and UR processes and personnel Adheres to internal controls established for department Performs related duties as required...CmsFull timeImmediate startCurative
Rusk, TX1 day ago$1,395 - $1,550 per week
...Educates physicians regarding InterQual criteria, documentation of patient acuity and treatment plan and the related expectations of CMS, JCAHO, NYS DOH and other regulatory bodies. Works in collaborative practice with Physicians and Physician extenders to actively...CmsWeekly payFull timeContract workLocumImmediate startTravelNurseSource
Texas1 day ago$1,422 - $1,580 per week
...Educates physicians regarding InterQual criteria, documentation of patient acuity and treatment plan and the related expectations of CMS, JCAHO, NYS DOH and other regulatory bodies. Works in collaborative practice with Physicians and Physician extenders to actively...CmsWeekly payFull timeContract workLocumImmediate startTravelNurseSource
Houston, TX1 day ago$1,760 per week
Registered Nurse (RN) | Case Manager Location: Fort Worth, TX Agency: TalentBurst, Inc. Pay: $1,760 per week Shift Information: Days - 5 days x 8 hours Contract Duration: 13 Weeks Start Date: 10/19/2026 About the Position TRAVEL-...CmsFull timeContract workLocal areaShift workDay shiftTalentBurst, Inc.
Fort Worth, TX1 day ago- ...are required. Demonstrated knowledge of: • NCQA Utilization Management Standards • URAC Utilization Management Standards • CMS Managed Care requirements • Texas Medicaid Managed Care regulations • Medical necessity review criteria, including InterQual®, MCG...Cms
University Health
San Antonio, TX10 hours ago $1,996 per week
...community with comprehensive care ~ Medical staff represents more than 31 medical specialties ~ Award-winning facility including 4-Star CMS Rating, Press Ganey Summit Award, and Joint Commission Top Performer recognition ~ Accredited Level IV Trauma Center and recognized...CmsFull timeContract workImmediate startShift workRevolution Healthcare Services
Texas1 day ago- ...required. Experience • Minimum of 3 years of clinical or home health experience required. • Knowledge of government programs (CMS), accountable care organizations (ACOs), HEDIS, and experience with payor cost sharing initiatives preferred. • Knowledge of...CmsFull timeWork at officeMonday to Friday
Christus Health
Irving, TX10 hours ago - ...Quantity of resources: 2 Duration: 6 months JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required skillset: MS Suite CPC certified CRC certified 5+ years of risk adjustment experience...Cms
Vytwo
Prosper, TX1 day ago - ...Austin health centers. Under the Credentialing Manager, you will verify credentials, maintain databases, and ensure compliance with CMS, NCQA, and Joint Commission standards while coordinating changes in privileges and demographics. This role supports HIPAA compliance...Cms
CommUnityCare
Austin, TX17 hours ago - Location: McAllen, Texas, United StatesCompany: DHR HealthPosted: 2026-09-18DHR Health in McAllen, TX is seeking a mid-level Medical Biller/Coder to assign and sequence ICD-10-CM, CPT/HCPCS codes, and apply billing modifiers. You will participate in staff meetings and contribute...Cms
DHR Health
Mcallen, TX8 days ago - ...findings from rounds with different departments throughout the system. Will support department(s) during all on-site accreditation and CMS surveys as required. Manages medium to high priority projects as assigned by department leadership. ~ EDUCATION/EXPERIENCE...CmsWork at office
University Health
San Antonio, TXmore than 2 months ago - Houston Methodist is seeking a Case Manager (RN) to plan case management, care transitions, and discharge planning for a targeted patient population. The CM works with physicians and the care team to ensure compassionate, efficient, quality care and desired outcomes. It...Cms
Houston Methodist
Houston, TX1 day ago - ...trends in order to improve the UM program. The role involves developing and maintaining efficient UM processes, staying current with CMS criteria, and participating in case reviews and medical necessity determinations. Qualified candidates will have an MD/DO/MBBS, board...CmsRemote work
Sacbar
San Antonio, TX3 days ago - .... Foster employee engagement, accountability, teamwork, and professional growth. Regulatory Compliance: Ensure compliance with CMS Conditions for Coverage, ESRD regulations, Joint Commission standards, state and federal requirements, and University Health policies...CmsRelocation package
University Health
Pleasanton, TX10 hours ago - ...or equivalent. Required • Minimum of three to five (3-5) years' experience in a Medicare health plan or Managed Care - Enrollment, Disenrollment and Reconciliation - Required. • Robust knowledge of Medicare and CMS enrollment and billing regulatory requirements....Cms
Saxon Global
Lake Dallas, TX4 days ago - ...information learned with team members. Assist in the development of tools, education, and workflow processes to assist the network in meeting CMS, ACO, documentation, and payor quality initiatives. Conducts internal review audits to facilitate feedback for documentation and...CmsFull timeWork at officeMonday to Friday
Christus Health
Irving, TX10 hours ago - ...severity of illness, risk of mortality, and appropriate reimbursement, while ensuring accurate reporting of outcomes. The CDI RN will query physicians to obtain precise documentation, educate care teams, and stay current with CMS rules and coding concepts. #J-18808-Ljbffr...CmsFull timeDay shift
Medical Center Health System
Odessa, TX5 days ago - Methodist Health System is seeking a detail‑oriented Coder 2 to support our Healthcare & Medical Services department. This role is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS codes to inpatient and outpatient encounters, ensuring compliance with federal...Cms
Methodist Health System
Dallas, TX3 days ago - ...supporting efficient revenue cycle operations. Key Responsibilities Prepare, review, and submit clean claims to insurance payers (CMS-1500 and/or UB-04) Verify patient insurance eligibility and coverage Ensure accuracy of patient demographics, charges, and...Cms
America's ER Medical Centers
Shenandoah, TX4 days ago - ...Specialist This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services CMCS, Managed Care Group (MCG). As a Health Insurance Specialist, GS-0107-13, serves as an expert...Cms
US Government Jobs
Dallas, TX1 day ago - Athra Systems is seeking an experienced Remote Behavioral Health Medical Coder to join our remote coding team. You will review provider documentation and assign ICD-10-CM, CPT, HCPCS, and E/M codes for behavioral health services, supporting accurate reimbursement and regulatory...CmsRemote work
Page Mechanical Group Inc
San Antonio, TX1 day ago - ...About Our Facility: ~ Combining advanced technology with compassionate care ~242-bed capacity with 13 operating rooms ~4-star CMS rating for overall quality and patient safety ~ We are the largest healthcare provider in South and Central Texas, operating 28 facilities...Cms
Methodist Stone Oak Hospital - HCA Healthcare
San Antonio, TX21 days ago - ...timekeeping regulations Participates in psychiatry QI/QM program Provides emergency psychiatric call Works effectively with all CMS and UR processes and personnel Adheres to internal controls established for department Performs related duties as required...Cms
CURAtive
Cleveland, TX3 days ago - ...of occupational therapy services Perform all other duties as assigned and as required to effectively treat patients Comply with all CMS documentation standards of practice daily with point of care documentations as indicated Performs other tasks as assigned by immediate...CmsTemporary workReliefImmediate start
Cedar Hill Healthcare Center
Plano, TX5 days ago - DLH Corporation is seeking a Configuration Management professional to support DoD programs, focusing on CM discipline across lifecycle from requirements to end-of-life. You will develop CMPs, CSARs, and support CM events such as CCB and TRB. Responsibilities include CM ...Cms
- ...fostering a culture of clinical excellence, regulatory integrity, and continuous improvement Ensure full compliance with UNOS/OPTN, CMS Conditions of Participation, and Joint Commission standards governing organ allocation and transplantation This role operates...Cms
University Health
Austin, TX4 days ago - About European Wax Center European Wax Center®, a leading beauty lifestyle brand founded in 2004, offers guests a full suite of waxing services and a proprietary line of beauty products. Focused on our vision of Revealing Beautiful Skin® , we provide a modern, luxurious...Cms
European Wax Center- Magnolia
Magnolia, TX5 days ago - ...Community Medical Services (CMS) is seeking a Substance Abuse Peer Support Specialist to assist patients in recovery from opioids and other substances. You will use personal recovery experience to provide guidance, coaching, and ongoing support in outpatient settings across...CmsShift work
Paylocity
San Antonio, TX17 hours ago - ...non-routine Perform documentation of all services provided Comply with facility Standard Operating Procedures to meet standards for accrediting agencies; specifically, Joint Commission guidelines, CMS Standards, BSH Policy and Directives, Rules and Directives....CmsFor contractors
GlobalPoint
Goodfellow Air Force Base, TX1 day ago
