Supervisor Healthcare Analysis Jobs in Pittsburgh

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 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 ..

... 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..

Specialty: Travel RN-DialysisJob Description The nephrology nurse is responsible for the care of pediatric and adult patients withkidney disease. The dialysis setting may be involved in the delivery of primary nursing ..

... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Pittsburgh Pennsylvania Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..

... 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 ..

Job Information Humana Automated Dispensing System (ADS) Compliance Technician in Pittsburgh Pennsylvania Description Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is ..

RN—ClinicalAbout this role: As a Dialysis Clinic Registered Nurse (RN) with Fresenius Medical Care, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing ..

Description The Supervisor, Care Management Support contributes to ... and wellbeing of members. The Supervisor, Care Management Support works within ... procedures; uses independent judgment requiring analysis of variable factors..

Job ID 21000LM1Available Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..

RN—ClinicalAbout this role: As a Dialysis Clinic Registered Nurse (RN) with Fresenius Medical Care, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing ..

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 ..

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..

Job ID 21000MGAAvailable Openings 2 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..

Description The Compliance (UM) Coordinator 3 conducts and summarizes compliance audits. The Compliance (UM) Coordinator 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical ..

Job ID 21000MG8Available Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..

PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality ..

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..

... 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..

Job ID 21000JP6Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

Job ID 21000NBVAvailable Openings 1Position Specific Information This position requires 100% travel Mon - Fri and will be remote Work from home when not travelling. Dialysis medical device and training experience ..

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 ..