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Description Crisis Nurses are needed for several hospitals in Northern NJ, We are looking for Specialty Registered Nurses to work in Tele, Med Surg, ICU or PCU 1. IDENTIFIES PATIENT CARE ..
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The Senior Company has EXPANDED and now has an office location in Union, NJ! We are looking for hourly Certified Home Health Aides and Certified Nursing Assistants to join our team ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work ..
... patient status regarding clinical, insurance, travel and transportation issues to the ... and physicians Position may require travel between assigned facilities and various ... various locations within the community...
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... leads, fee schedule reimbursement, needed travel for in person dental office ... on continuously improving consumer experiences Travel is required for this role ... per week or as necessary...
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Job ID 210004TMAvailable Openings 3Position Specific Information Located in Montclair, NJ Patient care experience strongly preferredPURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the ..
Job Information Humana Senior Accreditation Professional in Jersey City New Jersey Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to ..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
