Home Certification Specialist Jobs

Description The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other ..

... 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..

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 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 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, ..

Job Information Humana Care Team Medical Director in Washington District Of Columbia Description The Care Team Medical Director is responsible for improving the quality of care and outcomes while managing costs ..

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 - Medicare Pharmacy Appeals in Washington District Of Columbia Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work ..

Job Information Centerwell Occupational Therapist, Home Health Full Time in Washington ... Washington North Carolina As a Home Health Occupational Therapist , you ... evaluates Occupational Therapy Assistant and Home..

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 ..

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 UM Medical Director - Conviva in Washington District Of Columbia Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..

Job Information Kindred at Home Home Health Admissions RN, Offering up ... and other licensed clinicians and home health aides to ensure optimal ... At least 2 years clinical home..

HSCPC Rehab Technician - Pipeline','230001DO','!*!  The HSC Health Care System is a nonprofit organization combining the resources of a care coordination plan; (Health Services for Children with Special Needs, Inc.), pediatric ..

... 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..

Job Information Humana Medical Director - National Medicare Team in Washington District Of Columbia Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director ..

... 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..

... part-time, live-in, and overnight shifts. Home Care Assistance provides premier in-home senior care to help older ... help older adults thrive at home with optimal independence, health, safety .....

... Strategy Pharmacist - Work At Home in Washington District Of Columbia ... appropriate state Must have Board Certification Clinical experience in managed care ... Preferred Qualifications Board Certified Pharmacotherapy..

Job Information Humana Medical Director - Florida Medicaid in Washington District Of Columbia Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..

Description Job Description Summary 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 ..

Registered Nurse II (Experienced Critical Care RNs Only) - CICU, NICU, PICU or Critical Care Float Pool','2300009S','!*!The nurses at Children’s National are crafting ‘their story’ every day as they define and ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Washington District Of Columbia Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for ..