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... inpatient stay, and use of healthcare resources. The PA further acts ... appropriate tracking and trending for process improvement efforts. Attend and participate in ... and financial considerations of..
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... Identifies talent, conducts robust interview process for selecting highly qualified Field ... teams to share geographical and healthcare provider information within compliance boundaries. ... of FM in the submission..
u003cpu003eu003cstrongu003eThis job exists to:u003c/strongu003e perform audits of the documentation and posted CPT, HCPCs and ICD-10 codes of a sample of billed claims to determine whether services ordered by providers are rendered ..
Job ID 21000FD3Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
u003cpu003eu003cstrongu003eThis job exists to:u003c/strongu003e The purpose of this position is to maximize patient services revenue, in accordance with applicable federal and state laws, regulations, etc., and to provide effective leadership and ..
Description The Process Improvement Professional 2 analyzes, and measures ... sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments are ... Where you Come In..
u003cpu003eu003cstrongu003eThis job exists to u003c/strongu003eefficiently, effectively, and accurately convert patient encounters into reimbursable claims for timely payment from Clinicau0026rsquo;s payer mix.u003c/pu003enu003cpu003eAccept charges, review, analyze, and code diagnostic and procedural information that ..
Job ID 21000H1IAvailable Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Description The Experience Strategy & Transformation Lead enhances the consumer experience by architecting experiences and building capabilities that will positively impact our customers. The Experience Strategy & Transformation Lead works on ..
Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The Pharmacy ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Colorado Springs Colorado Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
u003cpu003eu003cstrongu003e*Must be bilingual in Spanish and English*u003c/strongu003eu003c/pu003enu003cpu003eu0026nbsp;u003c/pu003enu003cpu003eu003cstrongu003eThis job exists to:u003c/strongu003e The purpose of this position is to have a staff member who is fully cross trained in all aspects of administrative ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
Job ID 21000I3SAvailable Openings 2PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
Description Our search is focused on identifying a certified coder who will primarily be responsible for conducting prospective and concurrent reviews to identify documentation improvement opportunities according to CMS and ICD-10 ..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Senior Process Improvement Professional analyzes, and measures the ... sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately ... well as..
... development and implementation of quality improvement interventions and audits and assists ... multiple priorities Commitment to continuous process improvement Exceptional verbal and written communication ... degree Advanced degree in..
Description The Senior Stars Improvement, Clinical Professional responsible for the ... Stars Program. The Senior Stars Improvement, Clinical Professional work assignments involve ... factors. Responsibilities The Senior Stars Improvement, Clinical..
... that our members receive quality healthcare at an affordable price. You ... and recommendations Identify and suggest process improvement opportunities Develop and monitor team ... (RN) license 3 years..
Description The Senior Stars Clinical Professional (RN) works through phone calls and other outreach methods with members, providers, and/or vendors to close HEDIS care gaps. The Senior Stars Clinical Professional work ..