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... 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 ... by our comprehensive contract. Visit..
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..
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Description The Senior Compliance Professional ensures compliance with governmental requirements, ... of CenterWell Primary Care Organization provider clinics including serving as a ... care programs. The Senior Compliance Professional work..
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 Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
... Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home ... Description The Senior Process Improvement Professional analyzes, and measures the effectiveness ... improvements. The Senior..
... Medical Directors will learn Medicare, Medicaid, and Commercial requirements and will ... or upon request of the provider treating the member Supports and ... clinical and market leaders in..
... well-being. We also provide excellent professional development & continued education Responsibilities ... continued education Responsibilities The Senior Provider Installation Professional provides support to provider accounts by responding to inquiries..
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 ..
Job Information Humana Provider Contracting Professional 2 - Behavioral Health/Medicaid in Birmingham Alabama Description The ... in Birmingham Alabama Description The Provider Contracting Professional 2 initiates, negotiates, and executes .....
Description The CCM Compliance Professional 2 ensures compliance with governmental ... contractual requirements. The CCM Compliance Professional 2 work assignments are varied ... action. Responsibilities The CCM Compliance Professional 2..
... 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 Senior Market Development Professional provides support to assigned health ... support. The Senior Market Development Professional work assignments involve moderately complex ... Responsibilities The Senior Market Development Professional..
Job Information Humana Medical Director - Florida Medicaid in Birmingham Alabama Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
... Senior Contract Tools, Education, Processes Professional - Remote in Birmingham Alabama ... Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy ... Senior Contract Tools, Education, Processes..
Description The Senior Professional, Medicaid Network Strategy will be accountable ... development of Humana Healthy Horizon's (Medicaid) network and provider strategy for its growth markets. ... related to access to..
Description The Associate Director, Provider Contracting initiates, negotiates, and executes physician, ... executes physician, hospital, and/or other provider contracts and agreements. The Associate ... and agreements. The Associate Director, Provider..
... Medical Directors will learn KY Medicaid requirements, and will understand how ... related to care of a Medicaid population (TANF and expansion populations). ... industry including Medicare Advantage, Managed..
