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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 21000J5BAvailable 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. ..
Description iCare is seeking an Associate Director, Medicare Care Management who will lead teams of healthcare professionals responsible for care management. The Associate Director, Medicare Care Management role requires a solid ..
Job ID 21000MD4Available 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. ..
... 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..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Duluth Minnesota Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
... 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..
... who will lead teams of healthcare professionals responsible for care management ... to identifying and resolving complex technical and operational problems within department(s) ... revenue is optimized to best..
... 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..
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). ..
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 ..
... 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..
Job ID 21000MT2Available 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. ..
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 ..
