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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..
... 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 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..
... 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..
... 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 ..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical ... the Autism Care Demonstration (ACD) policy, TRICARE Operations Manual (TOM) Chapter ... session notes to the provider's claims..
... 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..
