Healthcare Resource Specialist Jobs

Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..

Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Albany New York Description Humana is seeking an experienced management professional to lead an interactive multidisciplinary team that helps translate the ..

Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Albany New York Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..

Location: Albany, New York Department: ABA Services Posted: 05/25/2023 Location Name: Albany Wage: TBD Come join a team of passionate therapists providing excellent pediatric therapy to children throughout the United States! ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Job Information Humana FP&A Lead, Medicaid Market in Albany New York Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..

Location: Albany, New York Department: ABA Services Posted: 05/25/2023 Location Name: Albany Wage: TBD Position Type: Part Time Come join a team of passionate therapists providing excellent pediatric therapy to children ..

... 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 Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..

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 Manager, Pharmacy and Medical Trend in Albany New York Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and ..

Admin / Clerical (188) Advanced Practice Registered Nurses / Physician Assistants (339) Allied Health (3185) Executive (81) Operations (252) Physicians/Surgeons (1354) Quality/Risk Management (19) Type Contract (1) Fellowship (0) Full Time ..

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..

Description The Medical Records Retrieval Representative (Risk Adjustment Representative 2) works with regional providers to utilize EMR access and other retrieval methods to retrieve member medical records that will be submitted ..

Contact Agency Corrections and Community Supervision, Department of Title Deputy Commissioner/Chief Medical Officer Occupational Category Administrative or General Management Salary Grade NS Bargaining Unit M/C - Management / Confidential (Unrepresented) Salary ..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Albany New York Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing ..

DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own.Connect with your goals and change liveswith ..

Job Information Humana UM Medical Director - Conviva in Albany New York Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..

... aptihealth team is comprised of healthcare, data science and technology experts ... experts passionate about transforming behavioral healthcare. aptihealth is a digital technology ... access speedy high quality behavioral..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Albany New York Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments ..

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

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 ..