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Description The Business Intelligence Lead solves complex business problems and issues using data from internal ... issues using data from internal and external sources to provide insight ... to decision-makers...
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... works within a framework of compliance expectations leading to significant variabilities ... responsible for the member's safety and advocacy outcome as part of ... facilitate access to the member..
... to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, ... uses clinical knowledge, communication skills, and independent critical thinking skills towards .....
... Openings 1Position Specific Information Full-TimePURPOSE AND SCOPE: Supports FMCNA’s mission, vision, ... FMCNA’s mission, vision, core values and customer service philosophy. Adheres to ... philosophy. Adheres to the FMCNA..
... purpose is to provide care management program support resources to physicians, ... resources to physicians, physician groups, and integrated healthcare delivery systems throughout ... caring for family, friends, finances,..
... authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests ... technical approach for project components, and work is performed without direction...
... factors. Responsibilities Location: work at home anywhere The Senior Clinical Delegation ... Vendor Oversight builds relationships with and provides clinical and operational oversight for third party ... technical approach..
Job ID 21000MCUAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, ... FMCNA’s mission, vision, core values and customer service philosophy. Adheres to ... philosophy. Adheres to the FMCNA Compliance..
... Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that ... communicates contract terms, payment structures, and reimbursement rates to..
Description The Behavioral Health Parity Compliance Lead will play an integral role ... integral role in the oversight and management of our Mental Health Parity ... of our Mental Health..
Job ID 21000N6DAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, ... FMCNA’s mission, vision, core values and customer service philosophy. Adheres to ... philosophy. Adheres to the FMCNA Compliance..
... Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that ... on problems of diverse scope and complexity ranging from..
Job Information Humana Senior Risk Management Professional - Third Party Risk Management-Remote, US in Atlanta Georgia Description ... Atlanta Georgia Description The Senior Risk Management Professional a critical member within..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in ... contribute to Humana's national planning and operations for Risk Adjustment, Stars, and Interoperability. Specifically, this role will..
... Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Atlanta Georgia Description ... is seeking an AVP to lead its Provider Support team and associate's..
PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, ... FMCNA’s mission, vision, core values and customer service philosophy. Adheres to ... philosophy. Adheres to the FMCNA Compliance Program, including following all..
