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Description The Director, Provider Reimbursement is responsible for the leadership, ... execution of Humana Military's provider reimbursement methodologies. This leader is responsible ... payment system software, and provider-specific reimbursement factors..
Description The Provider Relations/Engagement Professional 2 develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted ..
Description The Field Care Manager, Behavioral Health 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources ..
RN—ClinicalAbout this role: As a Dialysis Clinic Registered Nurse (RN) with Fresenius Medical Care, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing ..
Description The Bilingual Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions area. The Bilingual Consumer Service Operations Representative 3 performs advanced administrative/operational/customer support duties ..
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. Responsibilities ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Description The Provider Relations Manager - Behavioral Health (BH) oversees, leads, and supports a team of associates that grow positive, long-term relationships with contracted BH providers in order to facilitate a ..
Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..
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 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 ..
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 ..
Job Status: Full-Time Warby Parker is searching for skilled and enthusiastic Apprentice Optician to join our growing team of in-house optical all-stars and play an integral part in what we’re all ..
Description Medicaid- Behavior Health Provider Relations (PR) team maintains frontline relationships with network providers. Provider relations team members facilitate transparent and efficient processing of provider administrative matters to ensure reliable provider ..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the flexibility ..
Description The Social Services Care Manager, 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 facilitate interaction ..
