Healthcare Support Specialist Jobs

... facility The Supervisor, Care Management Support will lead a team of ... a team of 16-22 care support professionals and contributes to administration ... of care management. Provides non-clinical..

... also given the tools and support to make that change happen. ... We are the future of healthcare and our mission is to ... will help members through their..

... Job Description Summary Care Management Support Specialists contribute to the administration ... management. The CMSS provides non-clinical support to the assessment and evaluation ... and wellbeing of members. The..

... facilities, or community groups to support regional market care facilitation and ... or care management. Medical Directors support Humana values, and Humana's Bold ... whether services provided by other..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Honolulu Hawaii Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

Job Information Humana Medical Director - S. Florida in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

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 ..

Job Information Humana Medical Director - Florida Medicaid in Honolulu Hawaii Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

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 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 Description Founded in 1921, Straub Medical Center includes a 159-bed hospital in Honolulu, a network of neighborhood clinics and a visiting specialist program that reaches throughout the state of Hawai'i. ..

Job Description Kapi'olani Medical Specialists (KMS) is a specialty physician group dedicated to caring for Hawai'i's women and children through excellence in academics, physician training, medical research and clinical care. The ..

Job Information Humana Care Management Support Specialist in Honolulu Hawaii Description A ... all metrics established. Responsibilities The Support Specialist functions in a fast paced, ... and/or customer service experience..

... analytics. o Provide Market leader support reporting out on financial results, ... analysis for new contracts and support negotiations o Develop Market specific ... development o Provide leadership and..

... will collaborate with clinicians and support staff to provide Humana members ... involving an Administrative Law Judge, support for CMS audits, cross-functional team ... responsibilities as determined necessary to..

Job Information Humana Medicare Appeals and Grievance Medical Director in Honolulu Hawaii Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

... looking for an experienced Senior Healthcare Investigator to join its industry ... Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts ... Qualifications Bachelor's degree or significant..

... is looking for an experienced Healthcare Investigator to join its industry ... Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts ... areas Bachelor's degree or significant..

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 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 ..

Job Information Humana Clinical Pharmacy Lead, Remote in Honolulu Hawaii Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..

Job Information Humana Medical Director - National Medicare Team in Honolulu Hawaii Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..