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Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Senior Market ..
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Description The Quality Assurance, Clinical Professional 2 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work assignments are varied and ..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the ..
... review team is seeking a Medical Coding Auditor with a special ... review information provided in the medical records they must understand what ... this information confidently to other..
Description Be a part of the CenterWell leadership team, a subsidiary whose purpose is to provide care management program support resources to physicians, physician groups, and integrated healthcare delivery systems throughout ..
Description The Care Management Support Assistant 2 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
... the members we serve. The Medical Coding Auditor extracts clinical information ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and..
Description The Senior Quality Assurance, Clinical Professional requires being both a nurse/RN and a certified Coder nurse as this position will be cross trained to review DRG (Diagnosis Related Group) audits ..
... team with an Inpatient Senior Medical Coding Auditor roles! This is ... have a solid background in medical auditing, coding and medical record review? Well, if you ... should..
Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
... the team with a Senior Medical Coding Auditor roles! This is ... have a solid background in medical auditing, coding and medical record review? Well, if you ... should..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
Description The Care Management Support Assistant 2 (CMSA2) contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Description Humana is a $77 billion (Fortune 41) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Description The Stars Improvement, Clinical Professional 2 responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Stars Improvement, Clinical Professional 2 work assignments are varied ..
... audit/validation processes to ensure that medical record documentation and diagnosis coding ... optimal reimbursement. Validates and interprets medical documentation to ensure capture of ... with AAPC or AHIMA. Prior..
