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... 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..
... brand for a primary care medical group practice with centers open ... maintains patients' health information in medical records and charts. The Medical Records Clerk 2 performs varied .....
Job Information Humana Care Team Medical Director in Ridgeland Mississippi Description ... Mississippi Description The Care Team Medical Director is responsible for improving ... ground up. The Care Team Medical..
Job Information Humana FP&A Lead, Medicaid Market in Ridgeland Mississippi Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
... iCare is seeking an Enrollment Specialist who will support the iCare ... BadgerCare Plus. Responsibilities The Enrollment Specialist is responsible for iCare enrollment ... more years' experience in the..
... monitors drug development pipeline, and medical literature, while providing clinical support ... coverage policies for pharmacy and medical administered drug products. This individual ... Preferred Qualifications Board Certified Pharmacotherapy..
... team of 20-25 nurses and medical professionals that performs the following ... that performs the following functions: medical necessity/level of care reviews, provider ... education on the utilization and..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Ridgeland Mississippi Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special Investigations ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Ridgeland Mississippi Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
... Certified Diabetes Care and Education Specialist-Remote-US in Ridgeland Mississippi Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
Description The Behavioral Health Medical Director responsible for behavioral health ... and/or operations. The Behavioral Health Medical Director work assignments involve moderately ... Government Business's (HGB) Behavioral Health Medical Director..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... Government Business's (HGB) Behavioral Health..
... guidelines, enjoys researching and reviewing medical record documentation for incorrect billing ... Auditor 2 validates and interprets medical documentation to ensure capture of ... residence Minimum 2 years of..
Description The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of provider constituencies across all product lines, including Medicare, Medicaid and commercial. Primarily highly complex contracting arrangements. ..
... Coders are responsible for reviewing medical records, completing multiple audits, and ... while analyzing coding information and medical records. May participate in provider ... be used as a home..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
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 ..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... in reviewing actual and proposed medical care and services against established ... against established CMS and Humana..
Description The Medical Record Retrieval Specialist (Risk Adjustment Representative) travels to ... within the region and scans medical records into a secure system. ... Humana's Coding staff. Responsibilities The Medical..
... Information Humana Manager, Pharmacy and Medical Trend in Ridgeland Mississippi Description ... drug trends, both pharmacy and medical, as well as the impact ... Humana profitability. Responsibilities Lead our..
Description The Medical Director relies on fundamentals of ... C Line of Business. The Medical Director provides medical interpretation and determinations whether services ... a rotating basis Responsibilities The Medical..
... assignment capsule includes reviewing of medical records for fraud, waste or ... well as review of Humana Medical Coverage Policies, CMS regulations, peer ... vaccination or documentation for a..
Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Ridgeland Mississippi Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and scope ..