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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... administration determinations. The Manager, Utilization Management Nursing works within specific guidelines ... we succeed! The Manager, Utilization Management Nursing..
Job Information Humana Manager, Care Management(Behavioral Health) - Ohio Medicaid in ... is seeking Managers of Care Management who will lead our behavioral ... lead our behavioral health care management..
... is seeking Managers of Care Management (Physical Health & Behavioral Health) ... physical or behavioral health care management operations and staff to ensure ... Functions and Responsibilities: Supervise care..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Springfield Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Job Information Humana Senior Provider Contracting Professional - OH Medicaid in Springfield Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts ..
... field Prior experience with corporate management over direct reports Prior health ... verbal Strong organizational and project management skills For this job, associates ... done through an approved Humana..
Job Information Humana RN, Field Care Manager 2 - Maternity, L&D, Mother Baby (Ohio Medicaid) in Springfield Ohio Description Humana Healthy Horizons in Ohio is seeking a RN Field Care Manager ..
... choose to receive their care management from the MCO). Care Manager ... for TB. Preferred Qualifications Case Management Certification (CCM) Experience working with ... and dual-eligible populations Field Case..
... concepts to test Participates in vendor contract planning and implementing new ... or more years of product management experience and/or clinical implementation Leadership ... and Outlook Excellent organizational, time..
Job Information Humana Care Guide - Physical Health in Springfield Ohio Description The Care Guide (Care Coach 1) assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness ..
... choose to receive their care management from the MCO) and serves ... in behavioral health setting Case management experience Must be passionate about ... reliable vehicle. Preferred Qualifications: Case..
... meetings Required Qualifications Experience in healthcare, healthcare investigations, and/or risk management Supervisory or leadership experience Must ... Master's degree in Law, Business, Healthcare, or related field Extensive knowledge .....
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 Care Management Support Assistant 2 contributes to ... contributes to administration of Care Management. Provides non-clinical support to the ... for well-being Responsibilities The Care Management Support Assistant..
... OhioRISE Plan, and/or a Care Management Entity, or who choose to ... choose to receive their care management from the MCO. The BH ... Plan, CPCs, and/or a Care..
... providers on utilization and medical management processes. Enters and maintains pertinent ... clinical information in various medical management systems. Understands own work area ... plus. Previous experience in utilization..
Job Information Humana RN, Field Care Manager, Maternity, L&D, Mother Baby in Springfield Ohio Description Humana Healthy Horizons in Ohio is seeking a RN Field Care Manager 2 with Maternity, L&D, ..
Description Humana Healthy Horizons in Ohio is seeking a Care Guide/Care Guide Plus (Care Coach 1) who will assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness ..
... Horizons is seekign a Utilization Management Nurse 2 who utilizes clinical ... benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... 40 Company! Responsibilities The Utilization..
Description Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
