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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 ..
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 ..
Job Information Humana Clinical Pharmacy Lead, Remote in Omaha Nebraska Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..
Description The Clinical Pharmacy Lead for Pharmacy trend will be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual ..
Job Information Humana Medical Director - National Medicare Team in Omaha Nebraska Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..
Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
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 Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of ..
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 ..
Executive Representative II Hospital -- Omaha, NE Developing innovative therapies is one of the most challenging, most essential and personally rewarding fields in science. This is the most exciting time to ..
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 ..
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 Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Job Information Humana Medical Director - S. Florida in Omaha Nebraska Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana UM Medical Director - Conviva in Omaha Nebraska Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Medical Director - Florida Medicaid in Omaha Nebraska Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana FP&A Lead, Medicaid Market in Omaha Nebraska Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
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 ..
... 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..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..
