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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 ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... leadership and external exposure with healthcare providers in OH,..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Beckley West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Beckley West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Job Information Humana Contract Tools, Education, Processes Professional - Louisville, KY or Remote (EST hours) in Beckley West Virginia Description The Contract Tools, Education, Processes Professional builds templates, standard documentation, policy ..
Job ID 21000KBUAvailable Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Description The Physician Performance Insights team's mission is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain high quality ..
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 and PCS) to patient records. The Medical ..
... to resources, approach, and tactical operations for projects and initiatives involving ... their home. We are a healthcare company committed to putting health ... CCS, CFE, AHFI) Understanding of..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Beckley West Virginia Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts ..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Beckley West Virginia Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural ..
... guide and direct the overall operations, coordination and direction of nursing ... values and policies of Genesis HealthCare and in accordance with accepted ... action when necessary. Why Genesis?Genesis..
Description The Associate Director, Full Stack Engineering Performs software engineering activities in all layers of the stack, from setting up the database to programming in the back-end and the appearance at ..
Job ID 21000KRGAvailable 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. ..
... manage and oversee the daily operations of the dialysis clinic. You ... career into a Director of Operations then senior leadership role.Our culture: ... part of the future of..
Job Information Kindred at Home RN Clinical Manager in Beckley West Virginia The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, implements, analyzes, ..
