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Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Description The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied ..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
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 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 ..
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 ..
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 ..
Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
PURPOSE AND SCOPE:The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals’ policies and procedures. Areas of practice are ..
Job Information Humana Medical Director - National Medicare Team in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director ..
Job Information Humana Medicare Appeals and Grievance Medical Director in San Juan Puerto Rico Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for ..
Job Information Humana Medical Director - Texas in San Juan Puerto Rico Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested ..
Job Information Humana UM Medical Director - Conviva in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..
Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..
Job Information Humana Medicare/Medicaid Program Manager -- Remote in San Juan ... looking for an experienced Program Manager (internally known as an Acquisition ... contracts. As a Medicaid/Medicare Program Manager..
