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... assignment capsule includes reviewing of medical records for fraud, waste or abuse ... well as review of Humana Medical Coverage Policies, CMS regulations, peer ... assignment capsule includes reviewing..
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Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ... of variable factors. Responsibilities The Medical Director actively uses their..
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...
... order to prepare the Behavioral Health( BH) Clinical Team with the ... Experience working with the behavioral health population Excellent verbal and written ... investigative skills Excellent organizational and..
Job Information Humana UM Medical Director - Conviva in Fargo ... Fargo North Dakota Description The Medical Director relies on medical background and reviews health claims. The Medical Director work..
... 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..
... Clinical Review team working remote/from home anywhere in the U.S. Responsibilities ... assignment capsule includes reviewing of medical records for fraud, waste or abuse ... well as review of..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ... East Coast hours. Responsibilities The Medical Director actively uses their..
... trend while improving our member's health and costs Develop corporate communications ... Role Desirables Board Certified Pharmacotherapy Specialist (BCPS) Board Certified Oncology Pharmacist ... drug pipeline MBA, pharmacoeconomics or..
... Waste Investigator - Work At Home (Anywhere in the US) in ... Waste, and Abuse in the Health Care Industry? If this resonates ... Conducts on-site audits of provider..
... on opportunities to improve member health outcomes, member and care manager ... clinical quality, and savings to medical costs. The Strategy Advancement Lead ... priorities. Responsibilities Location: work at..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... 2 will collaborate with other health care providers in reviewing actual ... in reviewing actual and proposed..
... infusion medications. We believe the home has a unique value proposition ... as a site of care. Home-centric models can provide better patient ... migrate our Medicare members to..
... is responsible for ensuring the full range of network requirements for ... day of employment. Benefits include: Medical Benefits Dental Benefits Vision Benefits ... Benefits Dental Benefits Vision Benefits..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ... East Coast hours Responsibilities The Medical Director actively uses their..
... is acritical leadership role with full market financial oversight over the ... objectives o Responsible for identifying medical cost trends and leadership of ... cost trends and leadership of..
... and Waste Investigator-- REMOTE/WORK AT HOME in Fargo North Dakota Description ... Waste, and Abuse in the Health Care Industry? If this resonates ... Conducts on-site audits of provider..
... iCare is seeking an Enrollment Specialist who will support the iCare ... BadgerCare Plus. Responsibilities The Enrollment Specialist is responsible for iCare enrollment ... members, the Wisconsin Department of..
... Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in ... team of 20-25 nurses and medical professionals that performs the following ... that performs the following functions:..
... Coders are responsible for reviewing medical records, completing multiple audits, and special ... by clinical documentation within the health record. Follows state and federal ... while analyzing coding information..
... by clinical documentation within the health record. Follows state and federal ... while analyzing coding information and medical records. Decisions are regarding the daily ... Coders are responsible for..
