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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Job ID 21000KRGAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
... guidelines and procedures; applies advanced technical knowledge to solve moderately complex ... Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts ... their home. We are a..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
... The Lead Cloud Architect performs technical planning, architecture development and modification ... 8 or more years of technical experience 2 or more years ... for complex business problems Prior..
Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..
... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable healthcare while keeping our provider networks ... on existing data related and..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Beckley West Virginia Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts ..
... we value, care about, and support our people. We are there ... most, from tuition reimbursement to support your education goals, granting scholarships ... disasters strike, or providing financial..
... 40) market leader in integrated healthcare with a clearly defined purpose ... providing digital marketing funnel conversion support, enhancing SEO capabilities, and landing ... the moment of need for..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..