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... The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information ... The Senior Health Information Management Professional work assignments involve moderately complex .....
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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 ..
Description Location: Work from Home KY Medicaid Medical Director - The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given ..
Description The Supervisor, Health Information Management ensures data integrity for claims errors. The Supervisor, Health Information Management works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable ..
... 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..
... with contract and complex ACD policy requirements as defined by the ... 4. Responsibilities The Senior Compliance Professional responsibilities include analyzing data, reporting ... Demonstrates understanding of the ACD..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, ... contact, investigation, and settlement of claims for and against the organization. ... against the..
... 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..
... 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..
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..
... systems Understands own work area professional concepts/standards, regulations, strategies and operating ... guided by precedent and/or documented procedures/regulations/professional standards with some interpretation Required ... in multiple states without restriction...
Description The Health Information Management Professional 2 ensures data integrity for claims errors. The Health Information Management ... errors. The Health Information Management Professional 2 work assignments are varied and..
... 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..
... systems. Understands own work area professional concepts/standards, regulations, strategies and operating ... guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. What ... well-being. We also provide excellent..
... The Senior Medical/Financial Risk Evaluation Professional is responsible for supporting the ... The Senior Medical/Financial Risk Evaluation Professional work assignments involve moderately complex ... The Senior Medical/Financial Risk Evaluation..
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..
... and delivering on initiatives and process capabilities that enable improved effectiveness, ... identify, advise, lead and facilitate process improvement opportunities. KEY ACCOUNTABILITIES Process Improvement and Project Management Contributes .....
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 ..
... 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..
