Healthcare Credentialing Jobs in Las Vegas

Description The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value based care provider focused on quality of care for the patients we ..

Description We are excited to share that we are in the process of changing our name to CenterWell Senior Primary Care. We expect our name transition to be complete by the ..

Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..

POSITION SUMMARY: The Registered Nurse (RN) is an experienced registered professional nurse who initiates and coordinates the care plan, provides skilled and palliative care and coordinates the services provided to his/her ..

... 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,..

... 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 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 Las Vegas Nevada ... Nevada Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..

Salary: Open Categories: Physicians/Surgeons Internal Number: 40493 A DHMG-NV Internal Medicine Residency Core Faculty Location Facility: Dignity Health Medical Group - Nevada  Address: Las Vegas NV 89117 Opportunity Criteria Specialty: Academic ..

Posted: 01-Jun-23 Location: Las Vegas, NV, USA Salary: Open Categories: Advanced Practice Registered Nurses / Physician Assistants Nurse Practitioner Internal Number: 218140479 Physician Assistant US-NV-Las Vegas Job ID: 2022-37083 Type: Practitioner ..

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 ..

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 ..

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 ..

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 ..

PURPOSE AND SCOPE:Directs, administers and controls the day to day operations and activities of dialysis facilities and programs in an assigned area ensuring compliance with established company and regulatory guidelines and ..

n nn n  POSITION SUMMARY: The Registered Nurse (RN) Runner is an experienced registered professional nurse who is designated to provide coordination of care, ensure continuous assessment of each patient's and ..

Pediatric OphthalmologistnLocation: Las Vegas, NVnMPLT Healthcare is looking for physicians who ... benefits of working with MPLT Healthcare include:nn Flexibility u2013 work when, ... access to your personal MPLT Healthcare..

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 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 ..

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 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 ..

PURPOSE AND SCOPE: Promotes quality patient care, ongoing customer support and case management for Fresenius Medical Care (FMCNA) renal patient population (internal and external) by providing guidance, support, care coordination, education ..

Description The Network Operations Coordinator 3 manages provider data including but not limited to demographics and contract accuracy. Additional Information - How we Value You Benefits starting day 1 of employment ..