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Description The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires an in-depth ..
Job Information Humana Manager, Behavioral Provider Contracting - Remote in Bethesda Maryland Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and ..
Description The Associate Director, Credentialing/Compliance manages the Dental Credentialing and Compliance team ensuring that dental providers are Credentialed/Re-credentialed according to CMS and State guidelines and that Humana's Dental Networks operate in ..
Description The Director, Group Provider Strategy partners with the assigned Employer Group Market Presidents within the Region on the Employer Group provider strategy, provider performance and health plan contract compliance. The ..
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 The Vendor Management Lead works as liaison between vendors and organization. The Vendor Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities The ..
Description The Market Development Professional 2 provides support to assigned health plan relative to Medicare/Medicaid product implementation, operations, and contract compliance. The Market Development Professional 2 work assignments are varied and ..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..
*** Internal Only, In-line Promotion. Note: In the case of in-line promotions where there is an expansion of responsibilities for the incumbent in the role, which would result in the incumbent ..
Description The Associate Director, Medicaid Implementation (Project Management) manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Associate Director, ..
SUMMARY Stampede Ventures Inc., a subsidiary of Bering Straits Native Corporation is currently seeking a qualified, highly motivated Quality Control Manager (QCM) with DoD contract experience for government contracts in the ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Bethesda Maryland Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
... to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Director, Market ... internally and externally. Develop a contract management oversight process that allows ... allows..
Description The Director of User Acceptance Testing (UAT) drives performance and collaboration across the enterprise with the goal of ensuring user acceptance testing teams drive and deliver quality testing results based ..
Description The Medicaid Implementation Senior Project Manager manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Medicaid Implementation Senior ..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..
Description Responsibilities The Associate Director of IT Category Management will lead the team of Category Managers to drive cost savings via a robust 7-step process, oversee negotiations, implement contracts, and drive ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
Description The Associate Director, Consumer Experience ensures optimized interaction between a company and members. The Associate Director, Consumer Experience requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities ..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
