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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 DRG Validation 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 ..
Preventive Medicine Officer MAKE A DIFFERENCE IN THE LIVES OF OUR NATION’S DEFENDERS. Leverage your expertise to improve the health of our Soldiers and their families. As a preventive medicine officer ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Job Information Humana Bilingual Quality Auditor in Lancaster South Carolina Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. ..
Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..
Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST states Responsibilities The Bilingual Grievances ..
Description Are you passionate about contributing to the well-being of the Medicare population? Are you looking for a role that will let your creative ideas, relationship management and sales ability shine? ..
SoluStaff is recruiting a Certified Orthotist for its customer, a global healthcare tech company. The Certified Orthotist will provide exceptional patient care experience and oversee all stages of design, fabrication, fitting, ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Job Description Description All Charleston County Employees, as a condition of employment must be fully vaccinated against COVID-19 and provide their vaccination card. Seeking an experienced, dedicated, and licensed candidate to ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Seeking a BC/BE Interventional Radiologist for the Columbia, SC VAMC. Contract to start 8/1/21 for one year; will accept 6 months. Hours are M-F, 8-530. Call is 1:5 for one full ..
SC-10673-1 Daily duties / responsibilities: The principal duties of this position are to serve as a subject matter expert (SME) on the agency's financial accounting systems (SCEIS) and the claims processing ..
Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members ..
SC-10712-1 Specific duties include: Performs systems analysis activities for the Production MMRP systems. Gathers and develops business requirements and acceptance criteria for Production defects and enhancements Develops DDI artifacts compliant with ..
Description Humana's South Carolina Medicaid State Market Leader will be responsible for the overall strategic direction, oversight, and administration of programs and services for our Medicaid program in South Carolina. They ..
n n Helpn n Requirementsn Conditions of Employmentn n n n ntYou must be a U.S. Citizen to apply for this jobntAll applicants tentatively selected for VA employment in a testing ..
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 ..
