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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
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 ..
... audit folders. Update the web application tracking system. 15% Research provider ... Qualifications 2 plus years of healthcare experience Prior experience in Fraud, ... or Master's Degree in Business,..
Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
The City of Dover Fire & Rescue is accepting applications for the positions of fulltime Firefighter/EMT, as well as to produce an eligibility list for anticipated vacancies. Salary Range: $23.48 to ..
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 ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Job Information Humana Actuary, Risk and Compliance in Portsmouth New Hampshire Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare ..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Portsmouth New Hampshire Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review ..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Job Information Humana Clinical Pharmacy Lead, Remote in Portsmouth New Hampshire Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive ..
... Qualifications Bachelor's Degree in Business, Healthcare Administration, Mathematics and/or related field ... implementation technical experience Medicaid experience Healthcare and/or managed care experience Ability ... job as we are a..
Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Portsmouth New Hampshire Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and ..
Job Information Humana FP&A Lead, Medicaid Market in Portsmouth New Hampshire Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
Wentworth-Douglass Hospital, an affiliate of Mass General Brigham, is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and ..
