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Job Information Humana Grievances & Appeals Professional 2 - English/Spanish - Miami, FL in Miami Florida Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive ..
Description The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional ..
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As a Technical Client Services Manager you will manage day-to-day technical queries, investigations, and issues, maintaining subsequent technical relationships with internal and external IAS customers through to resolution, all within the ..
Description The Workforce Management Representative 4 applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, ..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Description The Senior Compliance Nurse reviews utilization management activities ... waste, and abuse. The Senior Compliance Nurse work assignments involve moderately ... variable factors. Responsibilities The Senior Compliance Nurse ensures..
SUMMARYThe Human Resources Generalist (HRG) manages the human resource function for the store operations in assigned regions to include staffing analysis, positive employee relations, training and development, recruiting and retention, and ..
Description The Compliance (UM) Lead conducts and summarizes ... (UM) Lead conducts and summarizes compliance audits. The Compliance (UM) Lead works on problems ... moderate to substantial. Responsibilities The Compliance..
Description The Senior Compliance Nurse reviews utilization management activities ... waste, and abuse. The Senior Compliance Nurse work assignments involve moderately ... Responsibilities Job Description The Senior Compliance Nurse ensures..
