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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 21000LWUAvailable 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. ..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Lima Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
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 ..
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 ..
Job Information Humana Senior Provider Contracting Professional - OH Medicaid in Lima Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts ..
... 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..
... 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..
... 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..
Job Information Humana Provider Contracting Professional 2 - OH Medicaid in Lima Ohio Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts under the Ohio Medicaid ..
Job Information Humana Care Guide - Physical Health in Lima Ohio Description The Care Guide (Care Coach 1) assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness ..
... 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). ..
