Healthcare Contract Specialist Jobs in Wisconsin

... 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..

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 ..

u003cpu003eu003cstrongu003eWho We Areu003c/strongu003eu003c/pu003enu003cpu003eu003ca href=u0022https://www.wpshealthsolutions.com/about/index.shtmlu0022 target=u0022_blanku0022 rel=u0022noopeneru0022u003eWPS Health Solutionsu003c/au003e is a leading not-for-profit health insurer in Wisconsin. Our services offer health insurance plans for individuals, families, seniors, and group plans for small ..

Description Humana/iCare is seeking a Senior Learning and Development Professional who will develop the training curriculum for the Family Care Partnership (FCP) department and will serve as the interface between the ..

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 ..

Job Information Humana Senior Contract Tools, Education, Processes Professional - ... Bay Wisconsin Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..

Job Information Humana Medical Director - Florida Medicaid in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..

... 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 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 Information Humana FP&A Lead, Medicaid Market in Green Bay Wisconsin Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..

Job Code 2168969I There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing ..

Posted: 23-Feb-22 Location: Appleton, Wisconsin Salary: Unpaid Categories: General Nursing Internal Number: 22001148_14 Description Registered Nurse Pediatric ICU AdventHealth for Children Up to $15,000 Sign-on Bonus and $5,000 Relocation available  for ..

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 ..

Job Information Humana UM Medical Director - Conviva in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..

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 ..

Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Green Bay Wisconsin Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Green Bay Wisconsin Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..

Job Information Humana Medical Director - National Medicare Team in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work ..

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 ..

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 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 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 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, ..