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Description The Senior Market Development Professional provides support to assigned health ... submissions. The Senior Market Development Professional work assignments involve moderately complex ... The Clinical Senior Market Development Professional..
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Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
... to enhance the clinical delivery process. The Associate Director, Compliance Nursing ... multiple managers or highly specialized professional associates. The Associate Director, Compliance ... Responsibilities include: Leads Medicaid operational..
... Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, ... Care Manager, Telephonic Behavioral Health 2 work assignments are varied and ... Care Manager, Telephonic Behavioral Health..
Description Humana's Claims Cost Management (CCM) organization is ... support our efforts for ensuring claims payment accuracy, so that our ... to day work of reviewing claims payments for clinical/coding..
... Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing ... reporting. The Consumer Service Operations Professional 2 evaluates metrics for early identification ... of..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination ... Cultural Competency Enable personal & professional growth Develop analytics and reporting ... business Actively identifies and owns process improvements and..
... to enhance the clinical delivery process. The Associate Director, Utilization Management ... multiple managers or highly specialized professional associates. Detailed Responsibilities include: Leads ... Leads National Medicaid Utilization Management..
... related issues which may include claims inquiries, enrollment issues, travel attestations, ... Manual (TRM), and the TRICARE Policy Manual (TPM). Assist with questions ... with qualifying ASD diagnoses. Provide..
Description The Medical Coding Coordinator 2 extracts clinical information from a ... records. The Medical Coding Coordinator 2 performs varied activities and moderately ... Responsibilities The Medical Coding Coordinator 2..
Description The Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
