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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 ..
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Job Information Humana Manager, Behavioral Provider Contracting - Remote ... in Brentwood Tennessee Description The Manager, of Behavioral Health Provider Contracting ... Behavioral Health Provider Contracting communicates contract terms, payment..
Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
Description The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied ..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary. The PDC Care..
... acumen to solve for the healthcare challenges of today. The Clinical ... low value care and related healthcare resource waste, with a focus ... news and reports in the..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Government. Responsibilities The Telephonic Care Manager will..
Description The Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
... include national clinical guidelines, Humana contract language, Humana coverage policies and ... whether services provided by other healthcare professionals are in agreement with ... with national guidelines, state mandates,..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..
Description Assignment Capsule: Be a part of a team that's dedicated to improving the health and well-being of our members, our associates, and the communities we serve. This position offers an ..
