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Description The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires an in-depth ..
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... processing operations and systems. The Director, Claims Oversight plays a vital ... relate to claims. Responsibilities The Director, Claims Quality Audit will oversee ... exceptional results to the TRICARE..
... will report directly to the Director of Value-Based Strategies - CMS ... Bachelor's Degree 5 years in healthcare management, consultation, or similar role ... in Business, Public Health, or..
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 Responsibilities The Associate Director for ACD Audit , at ... ACD Audit , at the director of the Director of Payment Integrity, will create ... optimizing operational processes. The..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description The Associate Director, Quality Assurance for Humana/Your Home ... Home Wellness Assessments. The Associate Director, Quality Assurance requires a solid ... care delivery. Responsibilities The Associate Director, Quality Assurance..
... Adheres to the FMCNA Compliance Program, including following all regulatory and ... requirements of the FMCNA Compliance Program, and FMS patient care and ... thresholds. Oversees facility’s Home Therapies..
Description As the Associate Director, IT Project Management, you will ... your background and experience in program management to lead and manage ... our Medicare segment. The Associate Director is..
Description The Director, Provider Reimbursement is responsible for ... team of associates. Responsibilities The Director, Provider Reimbursement develops and executes ... collaboration with other leaders, this Director will develop and..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Birmingham Alabama ... Birmingham Alabama Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
Description The Director of Health Services for National ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... the clinical delivery process. The Director of Health Services..
Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
... Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving ... to supplement Humana's Health Assessment Program. The summary of the IHWA ... for necessary follow-up care. This..
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 ..
Description The Director, Health Services utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health Services requires an in-depth understanding ..
Description The Director, Strategy Advancement provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at ..
Description The Director, Process Improvement analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Director, Process Improvement requires an in-depth understanding ..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description As the Director, Sales Product -Employer Group you will be responsible for defining and executing upon the sales product strategy & enablement plans across specific local markets and lines of ..
Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
Description The Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... clinical delivery process. The Associate Director, Utilization Management..
