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Description The Lead Medical Director relies on medical background and reviews health claims. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities The Lead ..
Job Information Humana Manager, Behavioral Provider Contracting - Remote in Fargo ... Fargo North Dakota Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment ... of those..
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 Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... care, and/or requested site of service should be authorized. All work ... inpatient, post-acute care environments, outpatient service requests, ER review, pharmacy review ... whether services provided by other..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, ... executes physician, hospital, and/or other provider behavioral health contracts for an ... Medicaid segment. Responsibilities The Director, Provider Contracting- Behavioral..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Government. Responsibilities The Telephonic..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary...
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
... (CCM) organization is seeking a Manager, Fraud & Waste to join ... & Waste to join the Provider Payment Integrity-Clinical Audit team working ... As the Fraud & Waste..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Description Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will assess, plan, coordinate, implement, ... Care Management Team, the care manager..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, ... executes physician, hospital, and/or other provider behavioral health contracts for an ... or segment. Responsibilities The Director, Provider Contracting- Behavioral..
