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... 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,..
Job ID 21000KLHAvailable Openings 1 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 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 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 ..
About this role: As a Biomedical Technician with Fresenius Medical Care, you will maintain and repair medical and water treatment equipment within our kidney care clinics. You will also train and ..
Telehealth, fully remote Therapist / Counselor opportunity for part-time or full-time. Bonus Offered Details: 100% remote work High volume of regular client referrals Therapy focused model with zero administrative work 5-40 ..
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 ..
... 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 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 ..
About this role:As a Social Worker with Fresenius Medical Care, you will provide psychosocial services for our dialysis clinic patients. You will work with the health care team to promote positive ..
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 ..
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 ..
Registered Behavior Technician - Competitive Wages - Train on the Job Proud Moments • Biloxi MS 39530 Job #2510090001 ID 2022-2454 Category ABA Therapy Position Type Part Time Overview Proud Moments ..
Job Information Humana Strategy Advisor, Healthcare Strategy in Ridgeland Mississippi Description ... Mississippi Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..
Description Join Humana's Talent Acquisition organization to support our growing Healthcare Services division! The Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment ..
Speech Language Pathologist (SLP) - Full Time, 30-40 Hours Per Week, Monday - Friday Skilled Care with some Psychiatric Care - Excellent Team in Place with GREAT Leadership! RP White and ..