Healthcare Credentialing Jobs in Bloomington

Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..

Job ID 21000BICAvailable Openings 1Position Specific Information This role requires floating throughout the state to cover as Clinical Manager as needed. PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and ..

... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... Medicaid business partners, including: Contracting, Credentialing, Referral/Authorizations, Claims, Grievance and Appeals, ... a Bachelor's degree in Business,..

... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..

Job ID 21000MX7Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

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 ..

University of Minnesota Physicians (M Physicians) is a non-profit organization seeking driven individuals in both clinical and non-clinical areas to help transform health and medicine. Headquartered in Minneapolis, our organization employs ..

PURPOSE AND SCOPE:Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality patient ..

Description The Senior Professional, Medicaid Network Strategy will be accountable for supporting the development of Humana Healthy Horizon's (Medicaid) network and provider strategy for its growth markets. This strategist will provide ..

Job ID 21000LFSAvailable Openings 2 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..

Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..

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 Strategy Advisor, Healthcare Strategy in Minneapolis Minnesota Description ... Minnesota Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..

University of Minnesota Physicians (M Physicians) is a non-profit organization seeking driven individuals in both clinical and non-clinical areas to help transform health and medicine. Headquartered in Minneapolis, our organization employs ..

PURPOSE AND SCOPE:Directs, administers and controls the day to day operations and activities of dialysis facilities and programs in an assigned area ensuring compliance with established company and regulatory guidelines and ..

$2,000 Sign-on Bonus! Salary: Starts at $58,327 The Certified Peer Specialist will promote hope and recovery by sharing life experiences and lessons learned as a person in recovery. The Peer Specialist ..

$2,000 Sign-on Bonus! Salary: Starts at $58,327 The Certified Peer Specialist will promote hope and recovery by sharing life experiences and lessons learned as a person in recovery. The Peer Specialist ..

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 ..

... the only way to drive healthcare forward and remain a global ... and payment advice in a healthcare setting with an emphasis on ... knowledge and understanding of U.S...

University of Minnesota Physicians (M Physicians) is a non-profit organization seeking driven individuals in both clinical and non-clinical areas to help transform health and medicine. Headquartered in Minneapolis, our organization employs ..

... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..

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'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 ..