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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..
Job Information Humana Manager of Fraud and Abuse Data Analytics in Pittsburgh Pennsylvania Description Responsibilities The Manager of Fraud and Abuse Data Analytics will be responsible for the supervision of the ..
**Company :**Allegheny Health Network**Job Description :**GENERAL OVERVIEW:Under the direction of the provider and as a member of the health care team, assists in coordinating the examination, treatment and health care planning ..
Job ID 21000JP6Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own. Connect with your goals and change ..
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 ..
**Company :**Allegheny Health Network**Job Description :****GENERAL OVERVIEW:**This job provides direct care to patients and assists with non-direct patient care unit coordination. The incumbent in this position is expected to perform basic ..
PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality ..
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 ..
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 ..