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... Lead role will assist the Supervisor in oversight & monitoring of ... requested by his or her supervisor, consistent with the purpose of ... company objectives . Required Qualifications..
Description The Supervisor, Inbound Contacts represents the company ... digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, ... procedures; uses independent judgment requiring analysis of variable factors..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description The Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
... requested by his or her supervisor, consistent with the purpose of ... Public Health Administration, Public Policy, Healthcare Economics, Business or related field ... expertise in population health, data..
... supervision, uses independent judgment requiring analysis of variable factors and determining ... requested by his or her supervisor, consistent with the purpose of ... Qualifications 3 plus years of..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Meridian Idaho Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
... a long-term care facility The Supervisor, Care Management Support will lead ... and wellbeing of members. The Supervisor, Care Management Support works within ... procedures; uses independent judgment requiring..
Description Responsibilities The Senior Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. Translates business needs into technical systems solutions. Integrates ..
... to complex issues where the analysis of situations or data requires ... to complex issues where the analysis of situations or data requires ... 25% Perform Project Planning and..
Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..
Description The Supervisor, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The Supervisor, Compliance Nursing works within thorough, ... procedures; uses independent judgment requiring analysis of variable factors..
