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... at Carilion Clinic, an award-winning healthcare network that includes seven hospitals, ... include: CHAM (Certified Hospital Access Manager) or CHAA (Certified Hospital Access ... through NAHAM (National Association of..
JOB SUMMARY The Senior Director of Clinical Advancement and patient safety assures that the Quality and Patient Safety corporate functions are carried out on a local level in such a manner ..
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... WA RN LICENSE The Care Manager, Telephonic Nurse 2 , in ... being of members. The Care Manager, Telephonic Nurse 2 work assignments ... of action. Responsibilities The Care..
Job ID 21000HQLAvailable 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 Provider Engagement Dedicated Care Manager develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within ..
Job specifications are intended to present a descriptive list of the range of duties performed by employees. Specifications are not intended to reflect all duties performed within the job. SUMMARY Bering ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... 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..
Job Information Humana Manager, Behavioral Provider Contracting - Remote in Glen Allen Virginia Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers ..
Description MUST BE BILINGUAL: CHINESE/ENGLISH (written and spoken proficiency) MUST HAVE WA RN LICENSE The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and ..
Description The Large Group Medical Underwriter computes rates for both renewing and prospective moderate to complex group accounts. The Large Group Underwriter 2 work assignments are varied and frequently require interpretation ..
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 ..
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 ..
u003cpu003eu003cstrongu003eRole Summary:u003c/strongu003eu003c/pu003enu003cpu003eResponsible for the performance, productivity and quality within the MVH business unit. Ensuring internal/external customer satisfaction and compliance with government contracts, laws and regulations. Oversees process improvement and implementation. Responsible ..
Description The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or ..
Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates new product ideas, enhance existing products or strategic product extensions, and translates research discoveries into marketable products. This ..
... (CCM) organization is seeking a Manager, Fraud & Waste to join ... As the Fraud & Waste Manager at Humana, you will support ... that our members receive quality..
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 ..
