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Description The Compliance (UM) Professional 2 conducts and ... Professional 2 conducts and summarizes compliance audits. The Compliance (UM) Professional 2 work assignments ... courses of action. Responsibilities The Compliance..
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... best and most appropriate treatment, care or services for members. Coordinates ... other parties to facilitate optimal care and treatment. Decisions are typically ... and processes necessary to maintain..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
... is seeking an Associate Director, Care Management leads teams of nurses ... behavior health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding .....
... to increasing patient access to care, lowering costs and improving the ... and improving the quality of care. Millions of times a day, ... shaping the future of health..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Job Information Humana Quality Improvement Coordinator in Jacksonville Florida Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The ..
... assessment generation. Ensures consistent team care scheduling and dissemination of updated ... updated clinical information. Coordinates assigned care team members and resources. Maintains ... practice Routinely complete Start of..
Job Information Humana Director, Care Delivery and EMR/EHR Technology in ... IT business initiatives specific to care delivery technology and the core ... capabilities interrelate across Humana's Primary Care segment,..
... is seeking an Associate Director, Care Management who will lead teams ... behavior health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding .....
... supportive of each other and care for each other as family. ... Transforming healthcare starts with taking care of our associates. We know ... Will Do Provide direct nursing..
... Middleburg Florida Description Humana's Primary Care Organization is one of the ... largest and fastest growing value-based care, senior-focused primary care providers in the country, operating ... Our Clinics..
... Park Florida Description Humana's Primary Care Organization is one of the ... largest and fastest growing value-based care, senior-focused primary care providers in the country, operating ... Our Clinics..
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 ..
... coordinates and oversees all direct care patient services provided by clinical ... operations for a specific location managed. Conducts/delegates the assessment and reassessment ... of patients, including updating of..
... contributes to the administration of Care Management and Utilization Management. The ... with appropriate resources for their care and wellbeing. Community Health Worker ... contributes to the administration of..
... Facility Administrator with Fresenius Medical Care, you will manage and oversee ... the provision of quality patient care in the dialysis clinic. Training ... important asset — we value,..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
