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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..
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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..
... background, health plan expertise and professional relationships to create, implement and ... Assist with network development and provider contracting with various providers and ancillary ... conversations with inpatient facilities..
... 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..
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..
... 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..
Job Information Humana Provider Contracting Professional 2 - Behavioral Health/Medicaid in Dover Delaware Description The ... in Dover Delaware Description The Provider Contracting Professional 2 initiates, negotiates, and executes .....
... Senior Contract Tools, Education, Processes Professional - Remote in Dover Delaware ... Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy ... Senior Contract Tools, Education, Processes..
Job Information Humana Medical Director - Florida Medicaid in Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Medical Director - Texas in Dover Delaware Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of ..
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 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 ..
... 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..
Job Information Humana Medical Director - National Medicare Team in Dover Delaware Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
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..
Job Information Humana Medical Director of Long Term Care, Florida in Dover Delaware Description The Long Term Care Medical Director supports the Long Term Care program in meeting optimal member outcomes, ..
... 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..
Description Job Description Summary 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 ..
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 UM Medical Director - Conviva in Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
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..
