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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 Genetic Counselor 2 responsible for evaluating and understanding member's risk of inherited medical condition. The Genetic Counselor 2 work assignments are varied and frequently require interpretation and independent determination ..
Job Information Humana Manager, Behavioral Provider Contracting - Remote in Green ... The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment ... The Manager, of Behavioral Health Provider..
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..
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 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 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 ..
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 ..
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 ..
u003cpu003eu003cstrongu003eRole Summaryu003c/strongu003eu003c/pu003enu003cpu003eResponsible for agency sales and retention of senior product lines, as well as providing support to Agency Manager and sales team to achieve goals.u003c/pu003enu003cpu003eu003cstrongu003eIn this role you will:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eMaintain regular contact ..
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 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..
Job Information Humana Provider Contracting Professional in Green Bay ... Green Bay Wisconsin Description The Provider Contracting Professional 2 Behavioral Health ... executes physician, hospital, and/or other provider contracts and..
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 - Behavioral Health ... Green Bay Wisconsin Description The Provider Contracting Professional 2 initiates, negotiates, ... health physician, hospital, and/or other provider contracts and..
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..
... Network Operations Coordinator 4 maintains provider relations to support customer service ... integrity management and gathering of provider data needed for service operations. ... Coordinator 4 manages and maintains..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
