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Job Information Humana Manager, Behavioral Provider Contracting in Dover Delaware Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and facilities. Analyzes ..
... team with a couple Senior Nurse Auditor roles! This is a ... details and a passion for healthcare? Do you have a solid ... should strongly consider the Senior..
... The Transplant Care Manager, Telephonic Nurse 2 , in a telephonic ... The Transplant Care Manager, Telephonic Nurse 2 work assignments are varied ... The Transplant Care Manager, Telephonic..
Description The WEEKEND Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
... of action. Role Requirements Registered Nurse or Behavioral Health professional 5 ... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural..
Description Humana's recently created Clinical Resource Team is looking to grow the team with an Inpatient Senior Medical Coding Auditor roles! This is a unique team that's primary role is to ..
... direct supervision of a licensed nurse in accordance with FMCNA policies, ... patient condition directly to the nurse supervisor. Observe patient, and conduct ... or unusual findings to the..
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 Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding of how organization capabilities ..
... physicians, physician groups, and integrated healthcare delivery systems throughout the country. ... delivery systems throughout the country. Healthcare isn't just about health anymore. ... of our members, and the..
Description The Nurse Auditor 2 performs clinical audit/validation ... to support optimal reimbursement. The Nurse Auditor 2 work assignments are ... overpayments when they happen. The Nurse Auditor 2 validates..
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 ..
... the team with a Senior Nurse Auditor roles! This is a ... details and a passion for healthcare? Do you have a solid ... should strongly consider the Senior..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Medical Coding Auditor roles! This is a unique team that's primary role is to quickly ..
Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, ... members. The Care Manager, Telephonic Nurse 2 work assignments are varied ... The Transplant Care Manager, Telephonic Nurse..
Job Information Humana Manager, Behavioral Provider Contracting - Remote in Dover Delaware Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and ..
