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Description The Lead Medical Director relies on medical background and reviews health claims. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities The Lead ..
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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 ..
Job Information Humana Manager, Behavioral Provider Contracting - Remote in Aberdeen ... The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment ... The Manager, of Behavioral Health Provider..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
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 ..
... & Waste to join the Provider Payment Integrity-Clinical Audit team working ... that our members receive quality healthcare at an affordable price. You ... (RN) license 3 years of..
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 Director, Provider Contracting- Behavioral Health Medicaid initiates, ... executes physician, hospital, and/or other provider behavioral health contracts for an ... Medicaid segment. Responsibilities The Director, Provider Contracting- Behavioral..
Description The Director, Provider Reimbursement is responsible for the ... and execution of Humana Military's provider reimbursement methodologies. This leader is ... prospective payment system software, and provider-specific reimbursement factors..
Description The Senior Provider Engagement, Clinical Professional develops and ... relationships with physicians, providers and healthcare systems in order to support ... the health plan. The Senior Provider Engagement, Clinical..
Description The Senior Provider Contracting Professional initiates, negotiates, and ... executes physician, hospital, and/or other provider contracts and agreements for an ... provides health insurance. The Senior Provider Contracting Professional..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, ... executes physician, hospital, and/or other provider behavioral health contracts for an ... or segment. Responsibilities The Director, Provider Contracting- Behavioral..
Job Information Humana Provider Contracting Professional in Aberdeen South ... Aberdeen South Dakota Description The Provider Contracting Professional 2 Behavioral Health ... executes physician, hospital, and/or other provider contracts and..
Description The Provider Contracting Executive initiates, negotiates, and ... executes physician, hospital, and/or other provider contracts and agreements for an ... that provides health insurance. The Provider Contracting Executive works..
Description The Provider Contracting Professional 2 initiates, negotiates, ... executes physician, hospital, and/or other provider contracts and agreements for an ... that provides health insurance. The Provider Contracting Professional 2..
Job Information Humana Provider Contracting Professional - Behavioral Health ... Aberdeen South Dakota Description The Provider Contracting Professional 2 initiates, negotiates, ... health physician, hospital, and/or other provider contracts and..
