Provider Contracting Professional 2 Jobs in North Carolina

Description Responsibilities The Senior Market/Industry Insights Professional delivers clinical/medical policy insight and information to both internal and external customers for Humana Government Business (HGB). The Senior Market/Industry Insights Professional will draft ..

Description Responsibilities The Senior Clinical Insights Professional delivers clinical policy insight and information to both internal and external customers for Humana Government Business (HGB). The Senior Clinical Insights Professional will draft ..

Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, ... executes physician, hospital, and/or other provider contracts and agreements for an ... provides health insurance. The Senior Provider..

Description The Director, Provider Reimbursement is responsible for the ... and execution of Humana Military's provider reimbursement methodologies. This leader is ... prospective payment system software, and provider-specific reimbursement factors..

Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..

Job Information Humana Provider Contracting Professional in Charlotte North Carolina Description ... Charlotte North Carolina Description The Provider Contracting Professional 2 Behavioral Health Network role; initiates, ... executes physician, hospital,..

... planning. Understands own work area professional concepts/standards, regulations, strategies and operating ... guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. The ... plus a minimum of two..

Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, ... executes physician, hospital, and/or other provider contracts and agreements for an ... provides health insurance. The Senior Provider..

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..

Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..

Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, ... executes physician, hospital, and/or other provider contracts and agreements for an ... provides health insurance. The Senior Provider..

Description The Payment Integrity Professional 2 uses technology and data mining, ... financial recovery. The Payment Integrity Professional 2 work assignments are varied and ... medical coding reviewer to handle..

... Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, ... Senior Clinical Strategy and Practice Professional work assignments involve moderately complex ... Responsibilities The Senior Behavioral Health..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..

Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Charlotte North Carolina Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..

Description The Provider Contracting Professional 2 initiates, negotiates, and executes physician, ... executes physician, hospital, and/or other provider contracts and agreements for an ... that provides health insurance. The Provider..

Job Information Humana Provider Contracting Professional - Behavioral Health in Charlotte ... Charlotte North Carolina Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral ... health physician, hospital,..

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 ..

Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Professional works on problems ..

... planning. Understands own work area professional concepts/standards, regulations, strategies and operating ... guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. The ... plus a minimum of two..

Description The Provider Contracting Professional 2 initiates, negotiates, and executes dental ... initiates, negotiates, and executes dental provider contracts and agreements for an ... that provides health insurance. The Provider..

Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term ... the health plan. The Senior Provider Engagement, Clinical Professional work assignments involve moderately complex ... variable factors...