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... 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 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..
... 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 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..
Job Information Humana Vendor Management Lead (Remote US) in Troy ... looking for an experienced Vendor Management Lead to join working remote ... in the US. The Vendor Management Lead..
... advising clients on issues in government and commercial contracts involving A&D ... researching the law applicable to government contracts and subcontracts, administrative law ... Should have organizational and project..
Job Information Humana Project Management Lead in Troy Michigan Description ... leading healthcare contractor! The Project Management Lead manages all aspects of ... and within budget. The Project Management Lead..
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..
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 ..
... 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..
... 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..
... let your creative ideas, relationship management and sales ability shine? If ... the day-to-day selling and/or account management activity. Accountable for achieving new ... 3 years of strong relationship..
... 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 Provider Data Management & Contract Load Professional in Troy Michigan ... Troy Michigan Description Provider Data Management & Contract Load Professional 2 is responsible ... provider accounts...
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 Vendor Management Professional 2 in Troy Michigan ... Michigan Description Responsibilities The Vendor Management Professional 2 works as liaison ... vendors and organization. The Vendor Management Professional..
... 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..
... years of experience in federal government contracts, with some experience in ... advising clients on issues in government and commercial contracts involving A&D ... researching the law applicable to..
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 Troy Michigan Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Compliance works within specific guidelines and procedures; applies ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Troy Michigan Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..
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 ..