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Attention I.T. professionals! Wisconsin is talking about TeamSoft! With over 40 clients in southern Wisconsin, TeamSoft will give you the best exposure to the widest range of I.T. careers possible. Whether ..
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... Information Humana Manager, Behavioral Provider Contracting - Remote in Green Bay ... Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, ... Manager, of Behavioral Health Provider..
Description The Provider Contracting Professional 2 initiates, negotiates, and ... provides health insurance. The Provider Contracting Professional 2 work assignments are ... of action. Responsibilities The Provider Contracting Professional 2..
Description The Network Operations Coordinator 4 maintains provider relations to support customer service activities through data integrity management and gathering of provider data needed for service operations. The Network Operations Coordinator ..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and ... segment. Responsibilities The Director, Provider Contracting- Behavioral Health communicates contract terms, ... Degree 5 plus years provider contracting experience,..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes ... health insurance. The Senior Provider Contracting Professional work assignments involve moderately ... (anywhere USA) The Senior Provider Contracting Professional..
... will be responsible for identifying, contracting and onboarding Home Health agencies ... administrative owner of the agency contracting and onboarding process. This person ... Administration support experience in a..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
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 Provider Contracting Professional in Green Bay Wisconsin ... Bay Wisconsin Description The Provider Contracting Professional 2 Behavioral Health Network ... agreements to include Medicare gap closing/contracting Responsibilities..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Green Bay Wisconsin Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
Job Information Humana Provider Contracting Professional - Behavioral Health in Green Bay Wisconsin Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts ..
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u003c/strongu003eu003c/pu003enu003cpu003eThe Clinical Supervisor (RN) will oversee a team of 20 to 30 remote Medical Review Nurseu0026nbsp; Analysts (NA) that complete Targeted Probe and Educate (TPE) work for our Medicare ..
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 Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description The Hospital Contracting Executive initiates, negotiates, and executes ... provides health insurance. The Hospital Contracting Executive works on problems of ... to substantial. Responsibilities The Hospital Contracting Executive communicates..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, ... segment. Responsibilities The Director, Provider Contracting- Behavioral Health Medicaid communicates contract ... Degree 5 plus years provider contracting experience,..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
