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Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
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Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
Job ID 21000A9DAvailable Openings 1Position Specific Information Located in Newark, NY $5,000 Sign-On Bonus Active RN (Registered Nurse) license required PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position ..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Job ID 21000GC8Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Job ID 210001ZHAvailable Openings 1Position Specific Information $5,000 Sign-On Bonus - One year Dialysis RN experience required Located in Batavia, NY Active RN (Registered Nurse) license required PURPOSE AND SCOPE: The ..
Job ID 21000FDXAvailable Openings 1DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient’s future—as well as your own. Connect with ..
Job ID 21000GS0Available Openings 2PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Job ID 21000EZOAvailable Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions ..
Job Information Humana Senior Accreditation Professional in Albany New York Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance ..
Description The Actuary, Analytics/Forecasting will develop the financial forecast for the dental and vision benefits included within Humana's growing Medicare Advantage business, as well as pricing and oversight of other stand ..
Job Information Humana Medicare Risk Adjustment Representative 3 (Scheduler) in Albany New York Description The Risk Adjustment Representative 3 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that ..
Job ID 21000F03Available Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions ..
Job ID 21000F0BAvailable Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions ..
Job ID 21000F4EAvailable Openings 1Position Specific Information Located in Hornell, NY $5,000 Sign-On Bonus Active RN (Registered Nurse) license required PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position ..
Job ID 21000ERIAvailable Openings 2 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Job ID 21000HOQAvailable Openings 1DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient’s future—as well as your own. Connect with ..
Job ID 21000ESTAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description Per Diem work available with flexible hours, including day, evening, weekend or a combination! Senior Bridge is seeking passionate, RN Home Care Nurse professionals dedicated to delivering the highest quality ..