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13,738 Job Information Deloitte Healthcare Data Analytics & Visualization Consultant ... in New York New York Healthcare Data Analytics and Visualization Consultant ... expertise on Medicare (preferably Claims) Healthcare Analytics..
16,436 Job Information Deloitte Federal Healthcare Data Analytics and Visualization Analyst in New York New York ... New York New York Federal Healthcare Data Analytics and Visualization Analyst Are you..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
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 Acts as the NY/NJ regional recruitment lead whose main task will be the primary resource for recruiting nonparticipating providers into the Aetna network based on high profile employer group ..
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 Job Description Summary 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 ..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Albany New York Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..
Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
Job OverviewWorks with production staff to establish procedures, technical business applications, and quality control procedures. Transitions existing clients to new systems in conjunction with IT development staff. Tests and validates data ..
... 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..
Description The Senior Market Development Professional provides support to assigned health plan(s) relative to Behavioral Health RFPs, product implementations and operational support. The Senior Market Development Professional work assignments involve moderately ..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Albany New York Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing ..
Job Title: Business Analyst 3 Location: 100% Remote (Remote, ... or data analysis preferably in healthcare or 5 years of HEDIS ... business process analysis, preferably in healthcare (i.e., documenting..
... Humana Lead Product Manager - Healthcare API in Albany New York ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Job ID 21000MDOAvailable Openings 1PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation ..
