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Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... variable factors. Responsibilities Job Title:..
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Description The Medical Coding Coordinator 3 extracts clinical ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM,..
... Director, Pharmacy Clinical Formulary and Medical Strategies requires a broad understanding ... execute on the formulary and medical drug strategies. Responsibilities The Director, ... Director, Pharmacy Clinical Formulary and..
Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a few powerful teams dedicated to reducing waste and abuse in the health care industry and its impacts on Humana. These teams ..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... of variable factors. Responsibilities The..
... support the coordination, documentation, and communication of medical services and/or benefit administration determinations. ... appropriate criteria to make a medical necessity determination. Complete telephonic, faxed, ... Case Management Discuss..
... be included in the patient medical records and support the provider ... Job Title: Your Home Advantage Medical Director Location: Louisville, KY or ... Certified in an approved ABMS..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
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 ..
Job Information Humana Senior Accreditation Professional in Birmingham Alabama Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 ... verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are ... Where you Come In The..
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 ..
... 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 Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Commercial requirements ... daily work. Responsibilities Title:..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... factors. Responsibilities Job Profile 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..
... 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 This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
