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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... Certified Diabetes Care and Education Specialist-Remote-US in Birmingham Alabama Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
... of coding practices and clinical documentation, grievance and appeals processes, and ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
Details Specialty: Interventional Cardiology Schedule: Full-time Practice Detail: 8-person employed Cardiology Practice EMR System: Athena Facility: Cardiology Specialists of Birmingham at Ascension St. Vincent's Location: Birmingham, AL Visa Eligibility: None Benefits ..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Birmingham Alabama Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing clinical ..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
Position Summary As a Clinical Research Coordinator II, you will work closely with the Principal Investigator, assisting with research study coordination and implementation, protocol eligibility, and participating in the informed consent ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Birmingham Alabama Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..
... is working hard at lowering healthcare administrative costs for federal government ... and modifiers from medical record documentation. Identifies and abstracts information from ... indicators that may require provider..
Admin / Clerical (197) Advanced Practice Registered Nurses / Physician Assistants (340) Allied Health (3222) Executive (80) Operations (255) Physicians/Surgeons (1359) Quality/Risk Management (18) Type Contract (1) Fellowship (0) Full Time ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... Qualifications Bachelor's degree or significant..
!*! To monitor and control one or more computer systems through operation of the central console and on-line terminals. To operate auxiliary equipment directly associated with computer systems. To continuously observe ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Birmingham Alabama Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
PURPOSE AND SCOPE: Supports FMCNA's mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions as the hemodialysis team leader ..
Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Birmingham Alabama Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and scope ..
Job Information Humana FP&A Lead, Medicaid Market in Birmingham Alabama Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
... is working hard at lowering healthcare administrative costs for federal government ... current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), ... quantities derived from medical record..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Birmingham Alabama Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Birmingham Alabama Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
... is looking for an experienced Healthcare Investigator to join its industry ... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... areas Bachelor's degree or significant..