Healthcare Credentialing Jobs in Pittsburgh

Liken HealthCare Staffing is looking to fill an immediate need for a Private Duty Aide in the Washington County area. The hours are, Monday through Friday, the client is flexible about ..

Job ID 21000JP6Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

... 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,..

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 ..

About this role:As a Social Worker with Fresenius Medical Care, you will provide psychosocial services for our dialysis clinic patients.  You will work with the health care team to promote positive ..

Job Information Humana Supervisor, Credentialing in Pittsburgh Pennsylvania Description Responsibilities ... Pennsylvania Description Responsibilities The Supervisor, Credentialing Operations is responsible for supervising ... years of experience in provider credentialing and/or..

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 ..

... 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..

Radiologist for Women's Imaging needed for succession planning at a large hospital facility in the greater Pittsburgh, PA area. Can be flexible with schedule. Must be BE/BC in Radiology and capable ..

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 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 ..

PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality ..

... Physician nLocation: Houston, TXn nMPLT Healthcare is looking for physicians who ... benefits of working with MPLT Healthcare include:nn Flexibility u2013 work when, ... access to your personal MPLT..

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 ..

Job Information Humana Strategy Advisor, Healthcare Strategy in Pittsburgh Pennsylvania Description ... Pennsylvania Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..

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 ..

Job Information Humana Manager, Credentialing in Pittsburgh Pennsylvania Description Responsibilities ... a team of certification and credentialing professionals that to ensure required ... contract requirements. Work collaboratively with credentialing leaders..

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 ..

About this role:As a Social Worker with Fresenius Medical Care, you will provide psychosocial services for our dialysis clinic patients.  You will work with the health care team to promote positive ..

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 ..

GastroenterologistnLocation: Pittsburgh, PAn nMPLT Healthcare is looking for physicians who ... benefits of working with MPLT Healthcare include:nn Flexibility u2013 work when, ... access to your personal MPLT Healthcare consultantn..

Hospitalist needed in Pittsburgh, PArnBC/BE IM HospitalistrnTues – Mon schedulern7a-7prnBackup Call 7p-7arnCoverage Details: The hospitalist covers 7A-7P working with an APP, then are on back up call for the APP that ..