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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 ..
Coding Specialist We have exciting employment opportunities ... Position Summary The HIM Coding Specialist will handle medical coding and ... and procedure codes based upon documentation in the medical record..
Job ID 21000MBOAvailable Openings 1PURPOSE 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. ..
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 ..
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 Description Introduction This position is time-limited to June 30, 2024 The Oklahoma State Department of Health (OSDH) is committed to leading Oklahoma to prosperity through health. Our mission is to ..
Job Description Introduction The Oklahoma State Department of Health (OSDH) is committed to leading Oklahoma to prosperity through health. Our mission is to protect and promote health, prevent disease and injury, ..
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 ..
... Certified Diabetes Care and Education Specialist-Remote-US in Tulsa Oklahoma Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Tulsa Oklahoma Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
... 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 Tulsa Oklahoma Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Job Description Introduction IF YOU ARE A CURRENT OR FORMER STATE EMPLOYEE, PLEASE APPLY TO THE INTERNAL JOBS LISTING HERE . DO NOT APPLY VIA THIS RECRUITMENT. This position is time-limited ..
Job Information Humana FP&A Lead, Medicaid Market in Tulsa Oklahoma Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
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 ..
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  Summary: Under the supervision of the RN Assists with the delivery of direct and indirect patient Care through the nursing process of Assessment Planning Intervention and Evaluation. Assists professional ..
... 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 Information Humana Medical Director - Medicare Pharmacy Appeals in Tulsa Oklahoma Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
... CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses ... correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, ... work experience with Coding and/or..