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... style=font-family: Calibri; font-size: 16px;\u003eA thriving healthcare system is seeking a BC/BE ... style=font-family: Calibri; font-size: 16px;\u003eAt NOW Healthcare Recruitment our goal is to ... style=font-family: Calibri; font-size: 16px;\u003eAbout NOW..
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 ..
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. The Utilization Management Nurse 2 work assignments ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Description Humana Healthy Horizons in Indiana is seeking Provider Claims Educators (Medicaid) who will be responsible for: conducting root cause analyses of claims data to track and trend claims denials or ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Indianapolis Indiana Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
Description The Remote Systems Clinical Pharmacist will provide excellent customer service to both internal and external customers by developing and maintaining relationships with Account / Clinical Management and PCO-IPU Operations teams. ..
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 Supervisor, Care Management Support 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 wellness ..
Description The Medical Records Retrieval Representative travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding staff. Responsibilities The ..
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 ..
Description Please note that this role requires you to work 4 days a week (including Saturday and Sunday), 10 hours a day, from your home office. If you cannot accommodate this ..
Work type: Full Time Administrative Location: Systems Office - Indianapolis, IN Categories: Administrative/Professional General Description of Position: The Assistant Vice President for Nursing (AVPN) has administrative oversight of the statewide associate ..
