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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 Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
We have an immediate opportunity for Admissions Coordinator The Admissions Coordinator serves as the point of contact for the clinical assessment process. Assesses by phone the needs of patient, collecting data ..
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 ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
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 Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
The Bradley Center is a trauma-focused residential treatment facility where children and adolescents with emotional, intellectual, and behavioral difficulties receive 24 hour care and treatment. Our residents present with a wide ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..
Job Information Humana Pharmacy Technician Networks Specialist, Remote PA or NJ in Pittsburgh Pennsylvania Description The Provider Contracting Administration Coordinator 2 supports the administration of the contracting function. The Provider Contracting ..
Job Location Canonsburg, PA - 5650 - Canonsburg, PA Position Type Full Time Salary Range $36,000.00 - $36,500.00 Salary/year There's a spot on our team waiting for you! Become a Team ..
Job Location Coraopolis, PA - 0600 - Coraopolis, PA Position Type Full Time Salary Range $39,000.00 - $41,000.00 Salary/year There's a spot on our team waiting for you! Become a Recreation ..
Description Job Description Summary 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 ..
Description The Medical Records Retrieval Representative travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding staff. Responsibilities The ..
AdvantageCare Rehabilitation is now hiring a Nurse Consultant Clinical Reimbursement Specialist to oversee our facilities in Western PA. This is a home based position, but travel throughout Western, PA and surrounding ..
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 ..
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 ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
