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... in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by ... state by guiding members/families toward and facilitate interaction with..
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Description Responsibilities The SIU and PPI Lab review team is ... person will focus on coding and clinical review of therapy claims: ... therapy claims: Physical, Speech, Occupational, and Chiropractic..
... in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain an optimal wellness state ... state by guiding members/families toward and facilitating interaction with..
... program for military members, retirees and their families. For more than ... to create better health outcomes and simplified experiences for millions of ... the United States through TRICARE..
... non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by ... state by guiding members/families toward and facilitate interaction..
... from Military Treatment Facilities (MTFs) and civilian providers for the ACD ... with a focus on administrative and customer support assignments. Typical work ... system with emphasis on accuracy..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is ... case management on at-risk beneficiaries and potential at-risk beneficiaries, as defined ... for independently completing timely reviews and decisions..
... a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) ... Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. .....
... environment. Our Counselor's provide ongoing and crisis intervention counseling focused on ... social, vocational, educational, health-related, developmental, and organizational concerns that impact daily ... in daily living, psychiatric crisis,..
... pricing assumptions, submitting bids, filing and gaining approval of premium rates ... gaining approval of premium rates and rate certifications with regulatory agencies. ... implementation of rates, new plans..
... The Associate Director, Problem, Incident and Event Management drives technical support ... The Associate Director, Problem, Incident and Event Management requires a solid ... The Associate Director, Problem, Incident..
... authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests ... 2 work assignments are varied and frequently require interpretation and independent..
... The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate ... other data to provide accurate and timely information for claims reserve ... claims..
... to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, ... Nursing works within specific guidelines and procedures; applies advanced technical knowledge .....
... Needs Plans provide personalized guidance and resources to help members get ... members get the right care and information based on their specific ... Are eligible for both Medicare..
Job Information Humana Social Worker-MSW and licensure required- Telephonic Behavioral Health-SNP- ... in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state..