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Job ID 21000JP6Available 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. ..
... 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,..
GastroenterologistnLocation: Pittsburgh, PAn nMPLT Healthcare is looking for physicians who ... benefits of working with MPLT Healthcare include:nn Flexibility u2013 work when, ... access to your personal MPLT Healthcare consultantn..
Job Information Humana Strategy Advisor, Healthcare Strategy in Pittsburgh Pennsylvania Description ... Pennsylvania Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..
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 Information Humana Supervisor, Credentialing in Pittsburgh Pennsylvania Description Responsibilities ... Pennsylvania Description Responsibilities The Supervisor, Credentialing Operations is responsible for supervising ... years of experience in provider credentialing and/or..
Locum Hospitalist needed outside of Pittsburgh and east of Latrobe, PA - Regional Medical Center-Rate: 190/hr, expenses paid-Start: February 2nd, 2022-Hospitalist-12 hr shifts, 7 on/off-Rounds on 18-22 patients-2 docs daily-NP helps ..
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 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 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 Manager, Credentialing in Pittsburgh Pennsylvania Description Responsibilities ... a team of certification and credentialing professionals that to ensure required ... contract requirements. Work collaboratively with credentialing leaders..
Description Job Description Summary 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 ..
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 ..
Radiologist for Women's Imaging needed for succession planning at a large hospital facility in the greater Pittsburgh, PA area. Can be flexible with schedule. Must be BE/BC in Radiology and capable ..
... 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..
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 ..
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 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 ..
Hospitalist needed in Pittsburgh, PArnBC/BE IM HospitalistrnTues – Mon schedulern7a-7prnBackup Call 7p-7arnCoverage Details: The hospitalist covers 7A-7P working with an APP, then are on back up call for the APP that ..
