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Description The Senior Policy Governance Professional policy Governance is the combination of Compliance processes established and executed that are reflected in the organization's structure and how it is managed and led ..
Description The Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
Description This is a salaried exempt position with responsibility for utilization management oversight and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in the TRICARE Operations Manual Chapter ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in San Antonio Texas Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
Description The Care Manager, Telephonic Behavioral Health 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 ..
Description The Care Management Support Assistant 3 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 ..
Description Responsibilities The ACD Referral Authorization Coordinator Lead role will assist the Supervisor in oversight & monitoring of processing and timeliness standards for referrals and authorizations under the Autism Care Demonstration ..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in San Antonio Texas Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..
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 ..
Job Information Humana Healthcare Lead Product Manager: Hispanic Segment Medicare Advantage in San Antonio Texas Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Hispanic MA customer ..
