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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. ... and reviews health claims. The Medical Director work assignments involve moderately ... of variable factors. Responsibilities The..
... review team is seeking a Medical Coding Auditor with a special ... review information provided in the medical records they must understand what each ... it should represented in..
Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Fargo North Dakota Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review ..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Fargo North Dakota Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Fargo North Dakota Description Humana is looking for an experienced Healthcare Investigator to join its ..
... 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..
... Information Humana Manager, Pharmacy and Medical Trend in Fargo North Dakota ... drug trends, both pharmacy and medical, as well as the impact ... Humana profitability. Responsibilities Lead our..
... opportunity for you.Banner - University Medical Center Tucson is nationally recognized ... cancer therapies. Banner - University Medical Center Tucson is a Level ... critically injured patients.The Banner University..
... 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..
Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
... 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 activities..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... East Coast hours Responsibilities The..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
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 Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Job Information Humana UM Medical Director - Conviva in Fargo ... Fargo North Dakota Description The Medical Director relies on medical background and reviews health claims. ... and reviews health..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... East Coast hours. Responsibilities The..
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...
Job Information Humana FP&A Lead, Medicaid Market in Fargo North Dakota Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
