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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 ..
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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..
Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, ..
... 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 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..
... Coding Supervisor, the Outpatient Coder 2 is responsible for a comprehensive ... accordance with official coding guidelines. 2. Reviews medical record documentation and ... code selection in a two..
... 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..
... 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..
... 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..
... Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, ... Senior Clinical Strategy and Practice Professional work assignments involve moderately complex ... Responsibilities The Senior 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..
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..
... clinicians. Recommend, develop and implement policy and procedures. Support special projects, ... the practice using these metrics/standards.. 2. Oversee the site supervisors/coordinators maintain ... trends. 3. Coordinate the on-boarding..
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 ..
... accordance with official coding guidelines. 2. Reviews medical record documentation and ... medical terminology, pathophysiology, and disease process. EXPERIENCE Requires a minimum of ... EXPERIENCE Requires a minimum of..
