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Description The Utilization Management Nurse 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 are ..
Description The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs administrative/operational/customer support/computational tasks. Typically works within a framework ..
... with Field Operations to address network inadequacy, and document barriers to ... with leaders for collaboration with network & non-network partners. Coordinate and track outcome ... Electronic Questionnaire for..
Description The Provider Contracting Coordinator 3 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Coordinator 3 performs ..
... with the plan COO, BH Coordinator, Quality Management Coordinator, and BH Medical Director to ... adequacy of the addiction provider network. Responsibilities Assist in the development ... management of..
... throughout health plan operations, provider network and community partnerships to achieve ... by the National Association of HealthCare Quality (NAHQ) or a Certified ... (NAHQ) or a Certified in..
... relationships with physicians, providers and healthcare systems in order to support ... provider relations, provider engagement and network development. They coordinate communication between ... communication between Humana and it's..
... Corporate Finance, Risk Management, Quality, Network, Member & Provider Services, Clinical, ... for any provider relations or network issues that may occur Implement ... years of experience working in..
Job Information Humana Medical Director of Long Term Care, Florida in Metairie Louisiana Description The Long Term Care Medical Director supports the Long Term Care program in meeting optimal member outcomes, ..
... Health Strategy Lead (Behavioral Health Coordinator) shall have responsibility for clinical ... Director. Regularly reviews integration performance, network adequacy, performance improvement projects, and ... closely with the Performance/Quality Improvement..
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 ..
WalgreensnJob DescriptionIn accordance with state and federal regulations, assists the pharmacist, under direct supervision, in the practice of pharmacy. Assists the pharmacist in the performance of other Pharmacy Department duties in ..
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 ..
Job Information Humana Provider Contracting Coordinator 3 - LA Medicaid in ... Louisiana Description The Provider Contracting Coordinator 3 initiates and finalizes behavioral ... agreements. Responsibilities The Provider Contracting Coordinator..
