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Description The Compliance Lead (Medicaid Contract Administrator) ensures compliance with governmental ... substantial. The Compliance Lead (Medicaid Contract Administrator) requires a solid understanding ... Responsibilities The Compliance Lead (Medicaid Contract..
... to the Vice President, Medical Management Operations and serves as a ... functions related to HGB's Care Management programs to include predictive models, ... corresponding support. Also leads Utilization..
... of variable factors. Responsibilities Humana Government Business's (HGB) Behavioral Health Medical ... the day-to-day administration and strategic management of behavioral and physical health ... physical health services, including utilization..
Description The Utilization Management Behavioral Health Professional 2 utilizes ... benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... of action. Responsibilities The Utilization Management Behavioral Health..
Description CenterWell Pharmacy is seeking a pharmacy contracting professional to solicit and maintain network agreements for all pharmacy lines of business. The pharmacy contracting professional 2 will be responsible for contracting ..
Job Information Humana Vendor Management Professional 2 in Lancaster South ... Carolina Description Responsibilities The Vendor Management Professional 2 works as liaison ... vendors and organization. The Vendor Management Professional..
... and possible participation in care management. The clinical scenarios predominantly arise ... health, or disease or care management. Medical Directors support Humana values, ... in teams focusing on quality..
Job Information Humana Vendor Management Lead (Remote US) in Lancaster ... looking for an experienced Vendor Management Lead to join working remote ... in the US. The Vendor Management Lead..
Description Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..
Job Information Humana Provider Data Management & Contract Load Professional in Lancaster South ... South Carolina Description Provider Data Management & Contract Load Professional 2 is responsible ... provider accounts...
Description The Care Management Support Assistant 3 contributes to ... contributes to administration of care management. Provides non-clinical support to the ... wellbeing of members. The Care Management Support Assistant..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Job Information Humana Senior Compliance Professional - Medicaid in Lancaster South Carolina Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional's work assignments involve moderately complex ..
... to substantial. Responsibilities The Utilization Management (UM) Process Improvement Lead analyzes ... and user groups for Medical Management IT systems changes and enhancements, ... to ensure alignment between medical..
... includes data entry into medical management system, assigning an appropriate provider, ... diagnoses and/or referral requiring Case Management, and pend to appropriate point ... discretion. Our Department of Defense..
Description Humana is seeking a pharmacy contracting professional to solicit and maintain network agreements for all pharmacy lines of business. The pharmacy contracting professional 2 will be responsible for contracting efforts ..
... by virtue of our TRICARE contract in which we provide healthcare ... leader to join the Humana Government Business (HGB) team as Associate ... a renewal of the TRICARE..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral ... involves processing referrals into medical management system with emphasis on accuracy ... answer provider/beneficiary inquiries. The Care Management Support..
Description Responsibilities The Utilization Management Nurse 2 will be responsible ... quality and clinical compliance with contract requirements as outlined in the ... codes. Our Department of Defense Contract requires..
... highly specialized professional associates. Our Government contract requires US CItizenship for this ... Engineering initiatives Team building and management Required Qualifications: Our Government contract requires US Citizenship for this..
Job Information Humana Project Management Lead in Lancaster South Carolina ... leading healthcare contractor! The Project Management Lead manages all aspects of ... and within budget. The Project Management Lead..
