Healthcare Credentialing Jobs in Newport

... 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,..

Clinician/ Intake Specialist, Flexible Schedule, Sign-on bonus (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof ..

Crisis Clinician/ Intake Specialist, Flexible Schedule, Sign-on bonus (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. ..

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 ..

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 Newport Rhode Island ... Island Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..

RN Team Lead (Full Time) Location: East Providence, RI The BH Link is searching for enthusiastic clinicians and counselors who are looking to make a positive impact in the Rhode Island ..

Crisis Clinician/ Intake Specialist (Full Time) Location: Providence,RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof of vaccination must ..

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 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 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 ..

BH Link Masters Level Clinician (Per Diem) (Per Diem) Location: East Providence, RI The BH Link is searching for enthusiastic clinicians and counselors who are looking to make a positive impact ..

Crisis Clinician/ Intake Specialist **3,000 Sign on bonus (Full Time) Location: Providence,RI **3,000 Sign on bonus Position Summary: Exciting opportunity to become a member of our dynamic behavioral health emergency services ..

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 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 ..

OVERNIGHT Registered Nurse 3-4 Day Work Week Full Time (Full Time) Location: East Providence, RI The BH Link is searching for enthusiastic clinicians and counselors who are looking to make a ..

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..

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 ..

Job Information Humana Manager, Credentialing in Newport Rhode Island Description ... a team of certification and credentialing professionals that to ensure required ... contract requirements. Work collaboratively with credentialing leaders..

Crisis Clinician/ Intake Specialist (Full Time) Location: Providence,RI Position Summary: Exciting opportunity to become a member of our dynamic behavioral health emergency services team. As a member of this team, you ..

Program Assistant - BH Link (Full Time) Location: East Providence, RI All staff must be vaccinated for COVID-19 prior to starting work, unless a certified medical exemption accommodation is granted. Proof ..