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Description The Field Care Manager NP assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for ..
Job Description This position is a Quality Monitoring position, at ActiveHealth, involving performance evaluations of Case Management staff for commercial and Medicare business. -Position may also be responsible for evaluations of ..
... preference with judicious use of healthcare resources Educates physicians regarding InterQual ... Educates physicians regarding InterQual criteria, documentation of patient acuity and treatment ... for high-risk patients across the..
... (POC). Monitors cases to ensure documentation is in compliance with regulatory ... own the review of clinical documentation in addition to feedback and ... Case Managers and clinical staff..
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 ..
Job Information Humana Senior Provider Contracting Professional in Greensboro North Carolina Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an ..
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 patient ..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Greensboro North Carolina Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts ..