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... problems and conditions using critical decision making to determine need for ... identification of and reporting of medical/healthcare errors. Protects the patient in ... or delegates tasks to designated..
RN, Case Manager','Full-time','Nursing - RN','8a','8a','80','80','Occasional','Occasional','KENTUCKY-LEXINGTON-SAINT JOSEPH EAST','','!*! Position Summary: Strives for excellence in patient care by assisting the patient and their families navigate the complex health care delivery system. Facilitates and ..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
Description Humana Healthy Horizons in Kentucky is seeking a Utilization Management Nurse 2 who will utilize their clinical nursing skills to support the coordination, documentation and communication of medical services and/or ..
... contract payments in our payer systems, and by ensuring correct claims ... their home. We are a healthcare company committed to putting health ... for optimal performance from Humana..
... group of patients with the support of PCTs to conduct patient ... off, PTO cash out * Support for you and your family: ... our teammates who work to..
... complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor ... diagnosis coding is accurate to support billed clinical diagnosis Applies clinical ... CCS, CRC, RHIA or RHIT)..
... activities and semi-routine assignments to support the Kentucky Medicaid Team. Responsibilities ... relationships with physicians, providers and healthcare systems in order to support operational and service related issues .....
... group of patients with the support of PCTs to conduct patient ... to patients at a contracted healthcare system, and become an integral ... off, PTO cash out *..
... of disease management software and systems as pertinent. STAFF: Responsible for ... recruitment and interview process, and decision to hire new personnel. Ensures ... members at regular intervals offering..
Job Information Humana Quality Improvement Coordinator in Lexington Kentucky Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The ..
... contract payments in our payer systems, and by ensuring correct claims ... job as we are a healthcare company committed to putting health ... for optimal performance from Humana..
... providers directly Multi-tasks in different systems Travel up to 20% In ... and network administration in a healthcare company Experience in contract preparation ... groups, ancillary providers and/or hospital..
Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... & Contracting leadership to provide support through complex analytics..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
