Health Information Specialist Jobs in Montpelier

Job Information Humana UM Medical Director - ... on medical background and reviews health claims. The Medical Director work ... phone to gather additional clinical information or discuss determinations regularly,..

Job Information Humana Clinical Formulary Strategy Pharmacist ... mitigate cost trend and improve health outcomes. The Clinical Formulary Strategy ... trend while improving our member's health and costs Serve as..

Responsible for performing all spa services including massage and body treatments. To provide a level of excellence in guest service to internal and external guests. Other responsibilities include various tasks for ..

... on medical background and reviews health claims. The Medical Director work ... Humana Government Business's (HGB) Behavioral Health Medical Director will provide clinical ... provide clinical oversight to Behavioral..

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 ..

Job Information Humana Medical Director - Medicare ... management organizations, hospitals/Integrated Delivery Systems, health insurance, or other healthcare providers, ... Advantage, managed Medicaid, or Commercial health insurance Experience with national..

... Enters and maintains pertinent clinical information in various medical management systems. ... English and Spanish strongly preferred. Health Plan experience working with large ... guidelines. Experience in leadership. Additional..

Job Information Humana Senior Clinical Pharmacy Advisor, ... members to achieve their best health through optimizing medication use. Responsibilities ... Preferred Qualifications: Board Certified Pharmacotherapy Specialist (BCPS) MBA, pharmacoeconomics or..

... 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..

Description The Lead Behavioral Health Medical Director oversees the work ... reviews themselves. The Lead Behavioral Health Medical Director may also lead ... modeling, best practice with behavioral health membership..

... phone to gather additional clinical information or discuss determinations regularly, and ... Directors and the Regional VP Health Services. After completion of structured ... management, discharge planning and/or home..

Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..

... on medical background and reviews health claims. The Medical Director work ... management, discharge planning and/or home health or rehab Preferred Qualifications Medical ... hospitals and experience, working with..

... strategy by collecting broad based information and gathering resources and data ... order to prepare the Behavioral Health( BH) Clinical Team with the ... corrected facility, MD, and diagnosis..

Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..

... 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..

Job Information Humana Pre- Authorization Nursing Supervisor-- ... management processes, entering/maintaining pertinent clinical information in various medical management systems. ... Qualifications Bilingual (Spanish) strongly preferred Health plan experience Prior Medicare/Medicaid..

Job Information Humana Medicare Appeals and Grievance Medical Director in Montpelier Vermont Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

... iCare is seeking an Enrollment Specialist who will support the iCare ... BadgerCare Plus. Responsibilities The Enrollment Specialist is responsible for iCare enrollment ... maintenance of the iCare eligibility..

Description The Behavioral Health Medical Director responsible for behavioral ... Medical Director responsible for behavioral health care strategy and/or operations. The ... strategy and/or operations. The Behavioral Health Medical Director..

Job Information Humana FP&A Lead, Medicaid Market ... to provide accurate and timely information for strategic and operational decisions. ... compiles, verifies, and analyzes financial information and economic indicators so..

Job Information Humana Fraud and Waste Investigator ... Waste, and Abuse in the Health Care Industry? If this resonates ... understanding of business operations Additional Information COVID Vaccination Policy: For..

Job Information Humana Senior Fraud and Waste ... Waste, and Abuse in the Health Care Industry? If this resonates ... understanding of business operations Additional Information COVID Vaccination Policy: For..