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Description The Quality Compliance Professional 2 completes annual quality ... reviews and research. The Quality Compliance Professional 2 work assignments are ... of action. Responsibilities The Quality Compliance Professional 2..
Job Information Humana Medicare Appeals and Grievance Medical Director in Anchorage Alaska Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Anchorage Alaska Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
... assigned patients. About Fairbanks Memorial Hospital Fairbanks Memorial Hospital is a non-profit facility owned ... by the Greater Fairbanks Community Hospital Foundation. A Joint Commission-accredited facility ... 152 licensed..
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 DRG Validation Auditor: REMOTE/Work At Home (Anywhere in the US) in Anchorage Alaska Description The DRG Validation Auditor extracts clinical information from a variety of medical records and ..
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 DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
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 Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Description The Senior Market Consultation/Partnership Professional promotes and improves the quality and measurement of care delivery programs with a market(s). The Senior Market Consultation/Partnership Professional work assignments involve moderately complex to ..
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 ..
... implement solutions. About Fairbanks Memorial Hospital Fairbanks Memorial Hospital is a non-profit facility owned ... by the Greater Fairbanks Community Hospital Foundation. A Joint Commission-accredited facility ... 152 licensed..
Job Information Humana DRG Validation Auditor: REMOTE/WFH (Anywhere in the US) in Anchorage Alaska Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
Manager, HIPAA and Healthcare Duties: The candidate is responsible for managing clients and projects, assisting in compiling and analyzing HIPAA (Health Insurance Portability and Accountability Act) documents and Protected Health Information/electronic ..
