Provider Contracting Professional Jobs in Pennsylvania

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

Description Responsibilities The Autism Care Demonstration (ACD) Senior Learning Design Professional analyzes content, organizes content, designs solutions, and writes storyboards, scripts, performance support, newsletters and notification letters. Analyzes learning needs and ..

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...

Job Information Humana Provider Contracting Professional in Pittsburgh Pennsylvania Description The ... in Pittsburgh Pennsylvania Description The Provider Contracting Professional 2 Behavioral Health Network role; ... executes physician, hospital, and/or..

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..

... 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 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 ..

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..

Job Information Humana Provider Contracting Professional - Behavioral Health in Pittsburgh ... in Pittsburgh Pennsylvania Description The Provider Contracting Professional 2 initiates, negotiates, and executes ... health physician, hospital, and/or..

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

Description Responsibilities The Compliance Professional 2 has responsibilities for performing ... beneficiaries' session notes to the provider's claims to determine whether all ... local team as needed for provider education..

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

Description The Provider Contracting Administration Coordinator 2 supports the ... supports the administration of the contracting function. The Provider Contracting Administration Coordinator 2 performs varied ... facilitate issue resolution in..

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 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 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 ..

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

Description Responsibilities This position will maintain the Humana Military ACD website Autism Center of Excellence (CoE); ensuring educational information is current and relevant to training needs in addition to analyzing and ..

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 ..