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Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate ..
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... to the member's physician and medical director for appropriate interventions Works closely ... case managers, attendings, PCP and medical director, community agencies and other approved ... patients with acute..
Description The Associate Director, Grievances & Appeals manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request ..
Job Information Humana Manager, Medicaid Provider Operations/Claims Research & Resolution- Work at Home FL in Tampa Florida Description The Manager, Claims Research & Resolution manages the daily operations that involve provider ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Profile..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately complex ... of variable factors. Responsibilities..
Job Information Humana Foundation Professional - Remote, FL in Tampa Florida Description The Foundation Professional is responsible for executing strategies in support of the Foundation's funding, research, and programmatic goals by ..
Job Information Humana Red Team Lead( virtual remote home office) in Tampa Florida Description Our Red Team Lead is responsible to lead a group a Red Team Operators through the design ..
... Humana IPA Clinical Consultant and Medical Leader - Conviva - South ... Responsibilities IPA Clinical Consultant and Medical Leader (CCML) will influence change ... The IPA Clinical Consultant and..
Description The Medical Director actively uses their medical background, experience, and judgement to ... and other sources of expertise. Medical Directors will learn Medicare and ... in their daily work...
Description The Chief Medical Officer, Group Medicare relies on the medical background to create and oversee clinical strategy for the Group Medicare business. The CMO Group Medicare, requires and in-depth understanding ..
Remote Inpatient Coding Opportunity – Full-time/Director Hire Requirements: 3+ years of Inpatient Coding, Auditing experience preferred Credentials: CCS, RHIT, or RHIA Required Reviews and evaluates hospital inpatient medical record documentation to ..
Job Information Humana Foundation Professional - Florida in Tampa Florida Description The Foundation Professional is responsible for executing strategies in support of the Foundation's funding, research, and programmatic goals by identifying ..
Description The Transplant Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates transplant members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families ..
Description o Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical ..
