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... customers Thought Leaders (TL) and Healthcare Providers (HCP) within assigned geography. ... Actively assess the medical and healthcare landscape by meeting with TLs/HCPs/access ... the competitive landscape and evolving..
Description The Provider Contracting Professional 2 initiates, negotiates, and ... provides health insurance. The Provider Contracting Professional 2 work assignments are ... of action. Responsibilities The Provider Contracting Professional 2..
PURPOSE AND SCOPE:The professional registered nurse Inpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 ..
Job ID 21000JNHAvailable Openings 1PURPOSE 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 ..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes ... health insurance. The Senior Provider Contracting Professional work assignments involve moderately ... factors. Responsibilities The Senior Provider Contracting Professional..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Description The Provider Contracting Professional initiates, negotiates, and executes ... provides health insurance. The Provider Contracting Professional work assignments are varied ... of action. Responsibilities The Provider Contracting Professional communicates..
... 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an accomplished healthcare leader for the newly-created role ... quality, appropriate, and cost-effective behavioral..
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 Staff Utilization Management Pharmacist/ Staff RX Clinical Programs /LT (Part Time Contract Position - Pharmacist - Remote, Puerto Rico in San Juan Puerto Rico Description The Staff Utilization ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..
... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... the value chain (i.e. claims, contracting and provider servicing). They will ... key Medicaid business partners, including:..
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 ..
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 Provider Contracting Professional - Behavioral Health in San Juan Puerto Rico Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider ..
Job Information Humana Provider Contracting Professional 2 - Remote Opportunity ... Puerto Rico Description The Provider Contracting Professional 2 initiates, negotiates, and ... provides health insurance. The Provider Contracting Professional..
Description The Provider Contracting Executive initiates, negotiates, and executes ... contracts and agreements. The Provider Contracting Executive engages in strategic negotiation ... and commercial. Primarily highly complex contracting arrangements. Responsibilities..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) ... Rico Description The Senior Provider Contracting Professional initiates, negotiates, and executes ... health insurance. The Senior Provider Contracting..
PURPOSE AND SCOPE:Supports the training and education of employees based in company facilities and programs within an assigned geographical area. Delivers standardized, competency based, training and development programs including new employee ..
Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... Provider Engagement, MRA, Clinical, & Contracting leadership to provide..
