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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,..
Pediatric OphthalmologistnLocation: Las Vegas, NVnMPLT Healthcare is looking for physicians who ... benefits of working with MPLT Healthcare include:nn Flexibility u2013 work when, ... access to your personal MPLT Healthcare..
n nn n POSITION SUMMARY: The Registered Nurse (RN) Runner is an experienced registered professional nurse who is designated to provide coordination of care, ensure continuous assessment of each patient's 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 ..
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 ..
Salary: Open Categories: Physicians/Surgeons Internal Number: 40493 A DHMG-NV Internal Medicine Residency Core Faculty Location Facility: Dignity Health Medical Group - Nevada Address: Las Vegas NV 89117 Opportunity Criteria Specialty: Academic ..
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 ..
Posted: 01-Jun-23 Location: Las Vegas, NV, USA Salary: Open Categories: Advanced Practice Registered Nurses / Physician Assistants Nurse Practitioner Internal Number: 218140479 Physician Assistant US-NV-Las Vegas Job ID: 2022-37083 Type: Practitioner ..
Description The Network Operations Coordinator 3 manages provider data including but not limited to demographics and contract accuracy. Additional Information - How we Value You Benefits starting day 1 of employment ..
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 ..
Job Information Humana Strategy Advisor, Healthcare Strategy in Las Vegas Nevada ... Nevada Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..
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 ..
POSITION SUMMARY: The Registered Nurse (RN) is an experienced registered professional nurse who initiates and coordinates the care plan, provides skilled and palliative care and coordinates the services provided to his/her ..
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 ..
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 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 ..
... 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: Promotes quality patient care, ongoing customer support and case management for Fresenius Medical Care (FMCNA) renal patient population (internal and external) by providing guidance, support, care coordination, education ..
