Healthcare Reimbursement Manager Jobs

Description The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires an in-depth ..

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..

Job Information Humana Manager, Behavioral Provider Contracting - Remote ... in Indianapolis Indiana Description The Manager, of Behavioral Health Provider Contracting ... contract terms, payment structures, and reimbursement rates to..

Job Information Humana Manager, Utilization Management Nursing - Medicare ... in Indianapolis Indiana Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management..

... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..

Job Information Humana Manager, Utilization Management RN - Remote ... in Indianapolis Indiana Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management..

... as directed by the Clinical Manager. Confer with physician in developing ... with physician orders, under Clinical Manager's supervision. Revise plan in consultation ... Coordinate appropriate care, encompassing various..

... any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, ... contact with patients, physicians, clinical manager(s), other members of the healthcare team in a timely manner .....

... 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..

Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..

... 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..

... at Home Registered Nurse Case Manager Full Time in Indianapolis Indiana ... a Home Health RN Case Manager , you will: Provide admission, ... as directed by the Clinical..

Job Information Humana Director, Contract Tools, Education, Processes (remote Eastern time zone) in Indianapolis Indiana Description The Director, Contract Tools, Education, Processes manages templates, standard documentation, policy and protocol, case studies, ..

Description The Senior Quality Compliance Nurse (RN) utilizes quality improvement methodology and works collaboratively with departmental and interdisciplinary teams to monitor quality, outcomes, and compliance processes. This role works with physicians/physician ..

Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Indianapolis Indiana Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

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 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 Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..

Job Information Humana UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Indianapolis Indiana Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, DME, and ..

Job Information Humana Manager, Fraud and Waste-Remote US in ... in Indianapolis Indiana Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..

Oncology Business Director Developing innovative therapies is one of the most challenging, most essential, and personally rewarding fields in science. This is the most exciting time to be a part of ..

... as directed by the Clinical Manager. Confer with physician in developing ... with physician orders, under Clinical Manager's supervision. Revise plan in consultation ... Coordinate appropriate care, encompassing various..