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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..
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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..
... implement, monitor, and evaluate the medical services required to meet the ... and to enhance quality of medical care. The case manager will ... for all activities within the..
... 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..
... 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..
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. Enjoy the flexibility of ... Management Behavioral Health Nurse completes medical record reviews from medical records sent from Behavioral Health ... of..
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 ..
... 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 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 ..
Job Information Humana Pharmacy Technician, Data Entry, Remote PA or TN ONLY in Pittsburgh Pennsylvania Description The Consultative Pharmacy Technician 2 certified Pharmacy Technician who data enters prescriptions and medication information ..
Job Information Humana Pharmacy Technician, Controlled Substance in Pittsburgh Pennsylvania Description The Consultative Pharmacy Technician 2 certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and ..
Job Information Humana Oncology Market Director in Pittsburgh Pennsylvania Description The Market Director, Oncology leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions to Humana ..
Bilingual Psychiatric Medical Director - to $270k DOE ... - to $270k DOE - Spanish SpeakingPhiladelphia, PArnWe are currently looking ... currently looking for a Psychiatric Medical Director to work..
... 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..
... 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..
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 ..
Job Information Humana Pharmacy Technician, Controlled Substance, Remote PA or TN in Pittsburgh Pennsylvania Description The Consultative Pharmacy Technician 2 certified Pharmacy Technician who acts as an intake for all calls ..
... brand for a primary care medical group practice with centers open ... lifelong well-being by giving our associate fresh perspective, new insights, and ... the Medicare population Proficient with..
