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... Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional consults and ... years of clinical experience within Home Health field Previous experience in ... reviews/auditing or extensive experience in..
... guidelines/procedures. Job Overview Humana At Home is a division of Humana ... Care Managers are work at home associates, working from a dedicated ... associates, working from a dedicated..
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 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 Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
... towards becoming a Pharmacy Technician Certification Board (PTCB) Certified Pharmacy Technician ... Personal DevelopmentEarns and maintains PTCB certification through the designated PTCB training ... training program and/or state required..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Green Bay Wisconsin Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..
... Required Qualifications AAPC or AHIMA certification required (CPC-A, CPC, CCS, CCA) ... in good standing with the certification governing body Must be willing ... and some overtime Work At..
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 The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
... degree Current and ongoing board certification in an approved ABMS Medical ... Lead Medical Director Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work..
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 ..
... American Board of Medical Specialty certification is psychiatry Preferred Qualifications Experience ... and/or special projects. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work..
... Waste Investigator - Work At Home (Anywhere in the US) in ... or work outside of their home. If progressed to offer, you ... exemptions are available. Work at..
... and Waste Investigator-- REMOTE/WORK AT HOME in Green Bay Wisconsin Description ... or work outside of their home. If progressed to offer, you ... exemptions are available. Work at..
Job Information Humana Medical Director - Florida Medicaid in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Job Information Humana UM Medical Director - Conviva in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Green Bay Wisconsin Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
... Qualifications AAPC or AHIMA coding certification required; CPC, CPC-A, or CCS ... in good standing with the certification governing body Effective written and ... is in a Work At..
Job Information Humana Medical Director - National Medicare Team in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work ..