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... 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..
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Description Healthcare isn't just about health anymore. It's about caring for ... one the nation's leading integrated health companies, Humana, we put the ... make our centers a leading health..
Description The Physician serves as a health-care professional and capable of handling a variety of health-related problems. The Physician work assignments involve moderately complex to complex issues where the analysis of ..
Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
Description Healthcare isn't just about health anymore. It's about caring for ... who assembles and maintains patients' health information in medical records and charts ... Processes and obtains accurate requested..
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..
... get the right care and information based on their specific condition ... condition(s): Have a specific chronic health condition Are eligible for both ... (see details below under Additional..
... Directing a team of Physical Health and Behavioral Health clinical leaders in fully developing ... for our industry-leading integrated Physical Health and Behavioral Health clinical model, including leading ongoing..
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 At Conviva Care Solutions, we want to inspire people to live life their best healthy life. Conviva Care Solutions is a management services organization representing nearly 300 physician practices, 800 ..
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 ..
... member's physical, environmental and psycho-social health issues. Identifies and resolves barriers ... Certified Diabetes Care and Education Specialist (CDCES) 3 - 5 years ... restrictions are lifted (See additional..
Description Healthcare isn't just about health anymore. It's about caring for ... care referral paperwork. Gathers pertinent information from physicians, nurse practitioners and ... Responds to patient inquiries regarding health..
Description The Compliance (UM) Lead conducts and summarizes compliance audits. The Compliance (UM) Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities The Compliance (UM) ..
... who assembles and maintains patients' health information in medical records and charts ... Processes and obtains accurate requested information ensuring proper release or request ... any changes when releasing..