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Job Information Humana Senior Provider Contracting Professional - Remote (EST ... Lima Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and ... executes physician, hospital, and/or other provider contracts..
Job Information Humana Provider Contracting Professional 2 - OH ... in Lima Ohio Description The Provider Contracting Professional 2 initiates, negotiates, ... negotiates, and executes behavioral health provider contracts under..
Job Information Humana Senior Provider Contracting Professional - OH Medicaid ... Lima Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and ... health physician, hospital, and/or other provider contracts..
Description The Provider Contracting Executive initiates, negotiates, and ... executes physician, hospital, and/or other provider contracts and agreements for an ... that provides health insurance. The Provider Contracting Executive works..
Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..
Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts under the Ohio Medicaid program. The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement ..
Description Humana Health Horizons in Ohio is seeking Field Care Managers, Behavioral Health 2 who will assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness state by ..
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 Humana Healthy Horizons in Ohio is seeking a Care Guide/Care Guide Plus (Care Coach 1) who will assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness ..
Job Information Humana RN, Field Care Manager 2 - Maternity, L&D, Mother Baby (Ohio Medicaid) in Lima Ohio Description Humana Healthy Horizons in Ohio is seeking a RN Field Care Manager ..
Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
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 ..
Description Humana Healthy Horizons is seekign a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Job Information Humana RN, Field Care Manager, Maternity, L&D, Mother Baby in Lima Ohio Description Humana Healthy Horizons in Ohio is seeking a RN Field Care Manager 2 with Maternity, L&D, ..
Description Humana Healthy Horizons is seeking a Pre-Authorization Nurse 1 who will review prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forwards requests ..
Job Information Humana Care Manager, Registered Nurse, RN in Lima Ohio Description Humana Healthy Horizons in Ohio is seeking a Field Care Manager to assess and evaluate member's needs and requirements ..
Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... closely with our local market Provider Engagement, MRA, Clinical,..
Description Humana Healthy Horizons in Ohio is seeking Managers of Care Management (Physical Health & Behavioral Health) who will lead our physical or behavioral health care management operations and staff to ..
... Programs Analyst supports successful value-based provider relationships in the Service Fund ... a focus on improving the provider experience and achieving path-to-value goals ... through analysis and reconciliation of..
Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..
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, CPT) to patient records. The Medical Coding ..
