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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 ..
... the global leader in dialysis healthcare, we form bonds that enable ... a member of the interdisciplinary healthcare team, supporting the FMCNA commitment ... guidelines. Maintains complete and accurate..
Job ID 21000LWVAvailable Openings 1PURPOSE AND SCOPE: Functions as the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Provides day to day direction and supervision to assigned ..
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 ..
... 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 Medicare Appeals and Grievance Medical Director in Ridgeland Mississippi Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
... 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..
Job ID 21000N5KAvailable Openings 1Position Specific Information Sign-on Bonus: $15,000PURPOSE AND SCOPE: Functions as the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Provides day to day ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Ridgeland Mississippi Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Apply Now Share this job Send yourself a reminder Alert me to jobs like this one Position Summary The position of Patient Access Specialist provides customer-service at all points of entry ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Ridgeland Mississippi Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..
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 FP&A Lead, Medicaid Market in Ridgeland Mississippi Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
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 ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
... Certified Diabetes Care and Education Specialist-Remote-US in Ridgeland Mississippi Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
Description The Medical Record Retrieval Specialist (Risk Adjustment Representative) travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding ..
Job ID 21000M7DAvailable Openings 1PURPOSE AND SCOPE: Functions as the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Provides day to day direction and supervision to assigned ..
Job ID 21000LRGAvailable Openings 1PURPOSE AND SCOPE: Functions as the hemodialysis team leader in the provision of chronic hemodialysis care and treatment. Provides day to day direction and supervision to assigned ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Ridgeland Mississippi Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
Remote Inpatient Coding Opportunity – Full-time/Director Hire Requirements: 3+ years of Inpatient Coding, Auditing experience preferred Credentials: CCS, RHIT, or RHIA Required Reviews and evaluates hospital inpatient medical record documentation to ..
