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... and patient safety. While this associate receives inbound calls, with limited ... and patient safety. While this associate receives inbound calls, up to ... information such as pharmacy; plan..
Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g. CPT)..
... coordination, documentation, and communication of medical services and/or benefit administration determinations. ... appropriate criteria to make a medical necessity determination. Complete telephonic, faxed, ... Case Management Discuss cases with..
... and in understandable terms, complex medical information from medical providers to patients, including interpretation ... terms information from patients to medical providers. Assists patients throughout the ... every patient..
Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... OR Provide documentation for a medical or religious exemption consideration. This ... oversight of their team this..
... A Telephonic Nurse 2 provides medical guidance, assists with access to ... assigned. Provide accurate and appropriate medical advice utilizing approved medical resources Utilizing available resources and ... fluently..
Job Information Humana Oncology Market Director in Boston Massachusetts Description The Market Director, Oncology leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions to Humana ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
... The Supervisor, Pre-Authorization Nursing: Completes medical necessity and level of care ... Educates providers on utilization and medical management processes. Enters and maintains ... pertinent clinical information in various..
... audit/validation processes to ensure that medical record documentation and diagnosis coding ... Auditor 2 validates and interprets medical documentation to ensure capture of ... Health field Previous experience in..
Description The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral ..
... coordination, documentation, and communication of medical services. Enjoy the flexibility of ... Management Behavioral Health Nurse completes medical record reviews from medical records sent from Behavioral Health ... of..
Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate ..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... OR Provide documentation for a medical or religious exemption consideration. This ... and intangible benefits such as..
... specialty programs, formulary strategies and medical strategies Outreach to oncology providers ... sigma experience and/or certification Multi-lingual (Spanish preferred) Understanding of medical claims, billing, and associated platforms ... first..
