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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Job ID 21000HVGAvailable Openings 1 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of ..
Description The Associate Director, Full Stack Engineering Performs software engineering activities in all layers of the stack, from setting up the database to programming in the back-end and the appearance at ..
Description Humana Healthy Horizons in Florida is seeking a STARS Improvement Professional 2 who will develop, implement, and manage oversight of the company's Medicaid Stars Program. They will direct all quality ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Charleston West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns ..
Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
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, ..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Charleston West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Description The 'voice of the provider' is key to Humana's integrated care delivery strategy. As Humana evolves from being recognized as a traditional payer to a health care company with deep ..
Description The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. This position will work and collaborate with ..
Job Information Humana Manager, Fraud and Waste-Remote US in ... Charleston West Virginia Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Charleston West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Charleston West Virginia Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Job Information Humana Medicare/Medicaid Program Manager -- Remote in Charleston West ... looking for an experienced Program Manager (internally known as an Acquisition ... contracts. As a Medicaid/Medicare Program Manager..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
