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Description The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other ..
Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team working remote/from home anywhere in the U.S. Responsibilities As a Board Certified ..
... member's physical, environmental and psycho-social health issues. Identifies and resolves barriers ... in achieving and maintaining optimum health. We provide telephonic outreach to ... to assess and support their..
... profitability while improving our member's health and costs. This role functions ... trend while improving our member's health and costs. Developing concrete trend ... trend mitigation opportunities from abstract..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
... profitability while improving our member's health and costs. This role functions ... of insights from the gathered information. Responsibilities Responsibilities include the following: ... Role Desirables Board Certified Pharmacotherapy..
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 Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
... on medical background and reviews health claims. The Medical Director work ... phone to gather additional clinical information or discuss determinations regularly, and ... relationships, value based care, population..
... hours as-needed. The On-Call Scheduling Specialist performs varied activities and moderately ... of the branch, the Scheduling Specialist may be responsible for part ... and accurately data enters the..
Job Information Humana Actuary, Risk and Compliance ... Compliance role assesses and communicates information regarding actuarial/business risks across the ... healthcare company committed to putting health and safety first for..
