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... conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that ... by clinical documentation within the health record. Follows state and federal ... while analyzing coding information..
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... Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional consults and collaborates ... years of clinical experience within Home Health field Previous experience in medical record reviews/auditing or extensive..
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..
... 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..
... 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..
... 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:..
Description The Medical Director actively uses their medical background, experience, and judgement to ... conferences, and other reference sources. Medical Directors will learn Medicare and ... daily work. Responsibilities Job..
... The Supervisor, Pre-Authorization Nursing: Completes medical necessity and level of care ... Educates providers on utilization and medical management processes. Enters and maintains ... pertinent clinical information in various..
... 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..
... 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..
Occupational Therapist HSC Home Care','230000DP','!*!The Occupational Therapist is a ... in daily life. Respond to medical referral following standard procedure. Individual ... 24 hours of treatment per home health care..
Job Information Humana UM Medical Director - Conviva in Washington ... District Of Columbia Description The Medical Director relies on medical background and reviews health claims. The Medical Director work..
... 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..
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..
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...
... 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..
... 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..
... 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 Job Description Summary The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ... factors. Responsibilities Job Description The Medical Director..
... 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..
... 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..
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..
