Provider Contracting Professional Jobs in Wisconsin

... The Senior Medical/Financial Risk Evaluation Professional is responsible for supporting the ... The Senior Medical/Financial Risk Evaluation Professional work assignments involve moderately complex ... The Senior Medical/Financial Risk Evaluation..

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..

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

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..

... 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 ... service for the elderly. Licensed..

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 ..

... 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 ... service for the elderly. Licensed..

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 ..

... 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 ... service for the elderly. Licensed..

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 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 Provider Contracting Professional - Behavioral Health in Green ... Green Bay Wisconsin Description The Provider Contracting Professional 2 initiates, negotiates, and executes ... health physician, hospital, and/or..

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 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 ..

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

u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u003c/strongu003eu003c/pu003enu003cpu003eThe Clinical Supervisor (RN) will oversee a team of 20 to 30 remote Medical Review Nurseu0026nbsp; Analysts (NA) that complete Targeted Probe and Educate (TPE) work for our Medicare ..

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 ..

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...

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..

... 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 ... service for the elderly. Licensed..

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 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 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 ..