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... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... Medicaid business partners, including: Contracting, Credentialing, Referral/Authorizations, Claims, Grievance and Appeals, ... a Bachelor's degree in Business,..
Job ID 21000KT8Available Openings 1PURPOSE AND SCOPE: Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing Social Work Theory of Human Behavior ..
Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..
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 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 ..
The Center for Disability Services offers hope, innovation and achievement to the people we support.For 80 years, we have been one of upstate New York’s largest providers of programs and services ..
Job Information Humana Supervisor, Credentialing in Albany New York Description ... York Description Responsibilities The Supervisor, Credentialing Operations is responsible for supervising ... years of experience in provider credentialing and/or..
The Center for Disability Services offers hope, innovation, and achievement to the people we support. For 80 years, we have been one of upstate New Yorku2019s largest providers of programs and ..
... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
Description Humana is a publicly traded, Fortune 50 healthcare company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in ..
Description Humana is a publicly traded, Fortune 100 health benefits company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company ..
Description Job Description Summary 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 ..
Contact Agency Mental Health, Office of Title Psychologist 2, Central New York Psychiatric Center – Coxsackie Residential Mental Health Unit, P24028 Occupational Category Health Care, Human/Social Services Salary Grade 23 Bargaining ..
Description The Senior Professional, Medicaid Network Strategy will be accountable for supporting the development of Humana Healthy Horizon's (Medicaid) network and provider strategy for its growth markets. This strategist will provide ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Job Information Humana Strategy Advisor, Healthcare Strategy in Albany New York ... York Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana, a Fortune 100 Healthcare..
Contact Agency Children & Family Services, Office of Title Child Protective Services Specialist 1 Occupational Category Enforcement or Protective Services Salary Grade 16 Bargaining Unit PS&T - Professional, Scientific, and Technical ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Contact Agency Mental Health, Office of Title Rehabilitation Counselor 2, Central New York Psychiatric Center – Coxsackie Mental Health Unit, P23993 Occupational Category Health Care, Human/Social Services Salary Grade 19 Bargaining ..
Job Information Humana Manager, Credentialing in Albany New York Description ... a team of certification and credentialing professionals that to ensure required ... contract requirements. Work collaboratively with credentialing leaders..
