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Job Information Humana Clinical Vendor Management Lead - Remote, FL in Naples Florida Description The Clinical Vendor Management Lead works as clinical liaison between vendors and organization. The Clinical Vendor Management ..
Job ID 21000NEJAvailable Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Job Information Humana Senior Provider Contracting Professional in Naples Florida Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts. The Senior Provider Contracting Professional ..
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 ..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
... (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..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Naples Florida Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..