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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 This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
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 ..
Description Humana Healthy Horizons in Louisiana is seeking a Crisis Service Liaison to join our growing team. The Crisis Service Liaison will have the primary responsibility of educating providers and those ..
Description Humana Healthy Horizons in Louisiana is seeking an Associate Director, Care Management(Behavioral Health) who will use clinical knowledge, communication skills, and independent critical thinking skills to provide the best and ..
Description The Care Management Support Assistant 2 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Description The Medicaid Housing Specialist (Care Management Support Professional 1)contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or ..
Description The Social Determinants of Health (SDOH) Coordinator understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed ..
Description The Field Care Manager, Behavioral Health 2 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 ..
Description The Community Health Worker/Care Management Support Professional 1 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or ..
Description Humana Healthy Horizons in Louisiana is seeking Behavioral Health Liaisons to join our growing team. The Behavioral Health (BH) Liaisons will be responsible for ensuring connection, coordination, outreach, education, and ..
Description Humana Health Horizons in Louisiana is seeking Medicaid Quality Audit Professionals - Behavior Health (BH) to ensure contracted Specialized Behavioral Health Providers adheres to NCQA documentation standards, BH Clinical Practice ..
Description The Provider Relations/Engagement Professional 2 develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted ..
