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... 340B Program including split-billing (outpatient), contract and specialty pharmacies. The Division ... with vendors, wholesalers, manufacturers, and contract pharmacies. The Division 340B Program ... Drug Discount Program, including ambulatory,..
... Position Summary The HIM Coding Specialist will handle medical coding and ... outpatient procedures consistent with client contract and documentation in the medical ... problem list consistent with client..
Job Information Humana Senior Contract Tools, Education, Processes Professional - ... Louisville Kentucky Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
Description The Medical Director is a leadership position that leverages medical expertise, understanding of the TRICARE business, and managed care to support and lead on both clinical programs as well as ..
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 ..
OverviewnThe Director, Behavioral Sciences and Psychiatry Services is responsible for directing the various components of the division of Behavioral Science in an efficient manner which will meet the ARH goals and ..
Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Louisville Kentucky Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..
Job Information Kindred at Home Healthcare Sales Representative - Home Health ... Kentucky As a Home Health Specialist , you will: Call on ... line extensions and proposal or contract..
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 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 Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Job Information Humana Supervisor, Care Management Support in Louisville Kentucky Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of ..
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 ..
... market contracting teams to influence specialist contract terms that align with Service ... in close coordination with PCP Contract Load, Capitation Rates, Payments, and ... Adjustments teams to ensure..
Description The Care Manager, Telephonic Nurse Assistant 3, in a telephonic environment, assess and evaluates beneficiary needs and requirements to achieve and/or maintain an optimal wellness state by guiding beneficiaries and ..
