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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..
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... 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,..
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..
... a culture of performance, collaboration and opportunity and this is what you get. ... health care data available wherever and whenever people need it, safely ... whenever people need..
... 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 21000MRBAvailable 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..
Job ID 21000MWDAvailable 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..
... 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...
... 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..
Job Information Humana Senior Risk Management Professional - Third Party Risk Management-Remote, US in Bethesda Maryland Description ... Bethesda Maryland Description The Senior Risk Management Professional a critical member within..
... 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 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 Bethesda Maryland Description ... is seeking an AVP to lead its Provider Support team and associate's..
... will work with payer contract management (commercial, Medicare, Medicaid), value-based contracts, ... (commercial, Medicare, Medicaid), value-based contracts, and managed care. Job Summary: Under ... organization (PHSO). This includes organizing..