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15,891 Job Information Deloitte Executive Account Director (Medicare/Medicaid) in Mechanicsburg Pennsylvania Are you an analytical, data-driven professional with strong leadership skills? Are you interested in a role that offers an opportunity ..
15,891 Job Information Deloitte SUR Specialist in Mechanicsburg Pennsylvania Are you an analytical, data-driven professional? Are you interested in a role that offers an opportunity to provide front line support to ..
15,891 Job Information Deloitte Functional Lead (Medicare/Medicaid) in Mechanicsburg Pennsylvania Are you an analytical, data-driven professional? Are you interested in a role that offers an opportunity to provide front line support ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Job Information Humana Senior Integration Specialist - Cloud in Pittsburgh Pennsylvania Description The Senior DevOps/Cloud Solutions Engineer Enables the automation of software code deployment by eliminating functional silos existing between development ..
... Qualifications Minimum 5 years of healthcare fraud investigations and/or auditing experience ... of Florida and Wisconsin Medicaid healthcare payment methodologies Strong organizational, interpersonal, and ... the required qualifications. Understanding..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Pittsburgh Pennsylvania Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description The UM Compliance Letters Specialist/Coordinator 2 contributes to administration of utilization management in the Compliance department. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
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 Site Reliability Engineering (SRE) Lead Technology Leadership Professional - Pharmacy Dispensing Solutions is responsible for all aspects of the production environment support strategy, Operational Excellence strategy and execution, and ..
Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Job Information Humana Lead Technology Leadership Professional (Service Accountability Lead - SAL) in Pittsburgh Pennsylvania Description Responsibilities Description The Lead Technology Leadership Professional is the Service Accountability Lead - SAL for ..
Job Information Humana Special Investigations Professional / Lab Investigator (Fraud, Waste & Abuse) Remote/Virtual in US in Pittsburgh Pennsylvania Description The Fraud and Waste Professional 2 conducts investigations of allegations of ..
Description The Medical Records Retrieval Representative travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding staff. Responsibilities The ..
Job Information Humana FP&A Lead, Medicaid Market in Pittsburgh Pennsylvania Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
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 ..