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... progress, and expedite responses from insurance carriers and other payers, and ... between the patient, physician and insurance company; compose clinical appeals letters ... document *Complete status check with..
Company Name: Kroger Specialty Pharmacy Position Type: Employee FLSA Status: Non-Exempt POSITION SUMMARY Perform duties to respond to incoming pharmacy calls from patients, prescribers' offices, insurance companies, and manufacturers, and employ ..
Job Information Humana Manager, Quality Compliance in Belle Chasse Louisiana Description ... other quality operations, improvement, and compliance functions. Audits processes as needed ... Audits processes as needed for compliance...
Description The Social Determinants of Health (SDOH) Coordinator understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed ..
Description The Community Health Worker/Care Management Support Professional 1 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or ..
Description The Medicaid Housing Specialist (Care Management Support Professional 1)contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or ..
Description Humana Healthy Horizons in Louisiana is seeking a Addictionologist/Addiction Services Manager (ASM) who will be responsible for overseeing the development and implementation of Humana Medicaid's Addiction Services in Louisiana, serving ..
... fraud, waste, and abuse (FWA) compliance program to prevent and detect ... out the provisions of the compliance plan, including FWA policies and ... Oversee internal investigations of FWA..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management (Behavioral Health) who will utilize clinical skills to support the coordination, documentation, and communication of behavioral health services and/or ..
Description Humana Healthy Horizons in Louisiana is seeking an Associate Director, Care Management(Behavioral Health) who will use clinical knowledge, communication skills, and independent critical thinking skills to provide the best and ..