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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..
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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 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 Boston Massachusetts Description The ... in Boston Massachusetts Description The Provider Contracting Professional 2 initiates, negotiates, and executes .....
... 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 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..
... 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 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 ..
... Senior Contract Tools, Education, Processes Professional - Remote in Boston Massachusetts ... Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy ... Senior Contract Tools, Education, Processes..
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 ..
... 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..
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..
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..
Job Information Humana UM Medical Director - Conviva in Boston Massachusetts 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 - Florida Medicaid in Boston Massachusetts Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
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 - National Medicare Team in Boston Massachusetts Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
