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Description The Health Information Management Professional 2 ensures data integrity for claim errors while maintaining ongoing research and special projects. The Health Information Management Professional 2 work assignments are varied and ..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
OverviewnPatient Access Educator is responsible for delivering individual and group on-the-job training to new and current patient access staff. Assist with the design and implementation of training tools, develop curricula and ..
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, ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
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 ..
... Certified Diabetes Care and Education Specialist-Remote-US in Louisville Kentucky Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
Job Information Humana Senior Quality Improvement Professional - EPSDT - Office ... Kentucky Description The Senior Quality Improvement Professional-EPSDT (Early Periodic Screening Diagnosis ... Diagnosis and Treatment) uses quality improvement..
Job Information Humana Medicare Appeals and Grievance Medical Director in Louisville Kentucky Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Health Information Management Professional 2 ensures data integrity for claim errors while focusing on provider education and ongoing research. The Health Information Management Professional 2 work assignments are varied ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
PURPOSE AND SCOPE:Knowledgeable, developing intermediate level technician performing normal functions under general supervision. Performs scheduled and unscheduled semi-routine repair, maintenance activities and operational condition of all medical equipment, water systems and ..
Description The Medical Director is a leadership position that leverages medical expertise, understanding of the TRICARE business, and managed care to support and lead on both clinical programs as well as ..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Job Information Humana FP&A Lead, Medicaid Market in Louisville Kentucky Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description The Supervisor for Clinical Intake leads a team of Inbound Customer Service Representatives supporting the Medicaid segment. This group responds to provider calls and outreach and addresses needs which may ..
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 ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Louisville Kentucky Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..