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Job Information Humana Clinical Vendor Management Lead - Remote, FL ... Naples Florida Description The Clinical Vendor Management Lead works as clinical ... vendors and organization. The Clinical Vendor Management..
Job Information Humana Clinical Vendor Management Lead - Remote, FL ... Myers Florida Description The Clinical Vendor Management Lead works as clinical ... vendors and organization. The Clinical Vendor Management..
... Qualifications Bachelor's degree in a healthcare field or equivalent experience. 5 ... years of experience in managed healthcare analysis, preferably as a Business ... done through an approved Humana..
... procedural and Florida Agency for Healthcare Administration (ACHA). Ensure adoption and ... compliance with Florida Agency for Healthcare Administration (ACHA), NCQA, Department of ... Bachelor's Degree in health services,..
Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... concepts to test Participates in vendor contract planning and implementing new ... Management experience Specialty Pharmacy experience Healthcare Industry experience Experience analyzing data, ... Growth mindset Project management experience..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires ..
... education. Required Qualifications - What it takes to Succeed Bachelor's Degree ... done through an approved Humana vendor, and unvaccinated associates should follow ... their home. We are a..
Description CarePlus is seeking a Clinical Business Lead who will lead teams of nurses and behavior health professionals responsible for Care Management and Utilization Management. The Clinical Business Lead works on ..
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 ..
Description The Care Management Support Assistant 2 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 ..
n The nurse practitioner is a member of the core interdisciplinary group whose primary function is to provide consultation in palliative care, symptom management and supportive care to meet the needs ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..
Description Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
... and network administration in a healthcare company Experience in contract preparation ... done through an approved Humana vendor, and unvaccinated associates should follow ... their home. We are a..
Job Information Humana Senior Provider Contracting Professional in Naples Florida Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts. The Senior Provider Contracting Professional ..
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 ..
Description Humana Healthy Horizons in Florida is seeking an Associate Director, Care Management who will lead teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care ..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
