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Description SeniorBridge: Together Changing Lives. SeniorBridge is Humana's wholly owned home care business acquired in 2012. At SeniorBridge, we're passionate about helping families and loved ones find solutions that make life ..
Description The RN, Compliance Nurse 2 reviews utilization management ... waste, and abuse. The RN Compliance Nurse 2 work assignments are ... of action. Responsibilities The RN Compliance Nurse 2..
Description The Learning Facilitation Professional 1 conducts or facilitates training courses for organization employees or external audiences. We are hiring in multiple locations: 2) Region 8 Sarasota, De-Soto, Charlotte, Glade, Lee, ..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Naples Florida Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..
... to ensure documentation is in compliance with regulatory agencies and requirements ... are completed timely and in compliance with Medicare regulations. Coordinates communication ... policies and procedures to ensure..
Job Information Humana Quality Improvement Coordinator in Naples Florida Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Job Information Kindred at Home Medical Records Specialist Home Health Full Time in Estero Florida The primary function of the Medical Records Specialist is to provide clerical support for the Medical ..
Job Description Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we're ..
Description Senior Compliance Professional ensures compliance with governmental requirements as they ... Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately ... variable factors. Responsibilities The Senior Compliance..
... quality of patient care, regulatory compliance, support of business development & ... fire and safety regulations in compliance with the company policies. Conducts ... Minimum of 2 years of..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care ..
