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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..
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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 ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Green Bay ... Bay Wisconsin Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
... Hiring Job Title: Regional Clinical Director Surgical Services Department: Surgical Services ... and more than 100 related healthcare facilities from Racine to Eagle ... throughout Wisconsin — Wheaton Franciscan..
... moderate to substantial. Responsibilities Humana Healthcare Research (HHR) needs your analytical ... tell a compelling story about healthcare today. Through the design and ... with meaningful real-life insights about..
Help seniors stay safely at home during this COVID-19 pandemic. By doing this, you will help ease the burden on the healthcare system and hospitals when they need it the most. ..
... commitment to the Quality Enhancement Program (QEP) and CQI Activities, including ... Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), ... There is a two-person assist..
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 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 ..
RN - Supervisor/Manager (Home Care - Oak Creek) (Full Time 1st shift) Location: Oak Creek, WI(53154) Horizon Home Care and Hospice, headquartered in Milwaukee, WI, is a home care and hospice ..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in Green Bay Wisconsin Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for ..
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..
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..
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 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 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, ..
Clinical Team Coordinator (Oak Creek) (Full Time 1st shift) Location: Oak Creek, WI(53154) In this important role you will efficiently coordinate the daily functions of our clinical team and assures effective ..
Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
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 ..
