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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 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 ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Troy Michigan Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
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 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 ..
Description The Nurse Auditor 2 will work on the clinical research and development team with coders, clinicians and genetic counselors to develop, implement and maintain clinical lab audit concepts. The Nurse ..
Description The Care Management Support Assistant 2 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 The CCM Compliance Professional 2 ensures compliance with governmental and contractual requirements. The CCM Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the ..
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 ..
... and issues related to Medicaid reimbursement. Will perform a variety of ... Will perform a variety of reimbursement tasks for new Medicaid states ... states including researching and documenting..
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 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 ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Description The Senior Value-Based Programs Professional supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Professional works on problems ..
Description The Financial Analytics Lead manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Lead works on problems of diverse ..
Description The Manager, Medical Coding oversees the coding team that is reviewing inpatient records for appropriate coding to include ICD-10, CPT, and HCPCS. The Manager, Medical Coding works within specific guidelines ..
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 Referrals Coordinator 2 processes referrals from Civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Typically works on semi-routine assignments. Responsibilities The Referrals ..
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 ..
Job Information Humana Quality Improvement Coordinator in Troy Michigan Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The ..
