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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 ..
... clinical suspects and appropriate clinical documentation and accurate coding. This role ... adjustment methodology gained from HCC documentation, coding and provider education experience. ... result in improved accuracy of..
... Medicare Risk Adjustment Coding & Documentation Improvement Professional - WAH AZ ... Medicare Risk Adjustment Coding & Documentation Improvement Professional Our search is ... closely with providers to identify..
... 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..
Job Information Humana FP&A Lead, Medicaid Market in Colorado Springs Colorado Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
... 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..
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 ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Colorado Springs Colorado Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Colorado Springs Colorado Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..
... 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..
... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Colorado Springs Colorado Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing ..
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 ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Colorado Springs Colorado Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
Job Information Humana Clinical Pharmacy Lead, Remote in Colorado Springs Colorado Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive ..
... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Colorado Springs Colorado Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and ..
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 ..
Description The Clinical Pharmacy Lead for Pharmacy trend will be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
Job Information Humana Medical Director - S. Florida in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
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 ..
