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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 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 ..
Job Information Humana Senior Provider Contracting Professional in Riverton Wyoming ... Riverton Wyoming Description The Senior Provider Contracting Professional initiates, negotiates, and ... executes physician, hospital, and/or other provider contracts..
Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness by guiding members/families toward resources appropriate for the ..
Description The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. This position will work and collaborate with ..
Description Humana Healthy Horizons in Florida is seeking a STARS Improvement Professional 2 who will develop, implement, and manage oversight of the company's Medicaid Stars Program. They will direct all quality ..
American Mobile Healthcare is seeking an experienced Medical ... to be approved as a provider under the Wyoming Breast and ... Job Benefits At American Mobile Healthcare we take care..
Description If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver exceptional ..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Senior Market Development Professional provides support to assigned health plan(s) relative to Behavioral Health RFPs, product implementations and operational support. The Senior Market Development Professional work assignments involve moderately ..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..
Job Information Humana Telephonic Behavioral Health Care Manager in Riverton Wyoming Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or ..
Job Information Humana Director, Provider Contracting - Behavioral Health Medicaid ... Riverton Wyoming Description The Director, Provider Contracting - Behavioral Health Medicaid ... executes physician, hospital, and/or other provider behavioral..
Description The Provider Contracting Professional 2 initiates, negotiates, ... executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Professional 2 work assignments ... courses of action. Responsibilities..
Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Riverton Wyoming Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
... Network Operations Coordinator 3 manages provider data including but not limited ... Network Operations Coordinator 3 manages provider data including but not limited ... demographics and contract accuracy. Manages..
... is looking for an experienced Healthcare Investigator to join its industry ... appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing ... areas Bachelor's degree or significant..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. Responsibilities The hours are Monday to Friday ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Riverton Wyoming Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..
Description The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization, with a focus on oncology requests. The Oncology ..
... organization is looking for Senior Provider Installation Professional to join the ... in the US. The Senior Provider Installation Professional administers the installation ... administers the installation of assigned..
