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Assistant General Counsel Duties: Provides advice to University departments and offices pertaining to various legal issues and obligations that may affect the University including, compliance with state and federal regulations, risk ..
Description The Care Management Support Assistant 2 contributes to ... contributes to administration of care management. Provides non-clinical support to the ... wellbeing of members. The Care Management Support Assistant..
... 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..
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 ..
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..
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 ..
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 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..
... 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..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Ridgeland Mississippi Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..
... 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..
... 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..
... 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..
Job Information Humana Vendor Management Lead (Remote US) in Ridgeland ... looking for an experienced Vendor Management Lead to join working remote ... in the US. The Vendor Management Lead..
Job Information Humana Provider Data Management & Contract Load Professional in Ridgeland Mississippi ... Ridgeland Mississippi Description Provider Data Management & Contract Load Professional 2 is responsible ... provider accounts...
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 ..
Assistant Counsel - Government Services Duties: Reviews and provides legal advice regarding Requests for Proposal/Qualifications and responses to same. Prepares legal documents, including contracts and legal memoranda. Reviews and responses to ..
... 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..
... 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 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 Manager, Compliance - Agent Investigation Unit in Ridgeland Mississippi Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Compliance works within specific guidelines and procedures; applies ..
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..