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... monitors trends in incidents and system issues and helps drive technical ... technology platforms / applications, performs system analysis and translates into system requirements. The work assignments are .....
Description The Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
... for a Senior Business Systems Analyst to join working remote anywhere ... US! The Senior Business Systems Analyst performs analysis of business, process ... analysis and translation into proper..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Job Information Humana Senior Copy Writer in Troy Michigan Description Humana's The Hive is looking for a Senior Copy Writer to join the team! The Hive is Humana's in-house agency, a ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records, and reviews medical documentation for clinical indicators to ensure specific procedures meet clinical criteria and correct coding ..
Description The Market Development Professional 2 provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Market Development ..
Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
... and documentation within a tracking system. May assist with identifying and ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting experience ... in..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the ..
... analysis and translation into proper system requirement specifications. The Senior Business ... Define Systems and Objectives Define system deliverables based on business objectives ... Project Testing and Implementation Prepare..
Job Information Humana Data Manager / ETL Developer - Primary Care Organization in Troy Michigan Description The Data Manager 2 supports all aspects of configuration control, data management, and deficiency reporting. ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Troy Michigan Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
... Humana Lead Product Manager - Healthcare API in Troy Michigan Description ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
... streams and understand how critical it is to work in an ... such as software development, engineering, IT, and a wide variety of ... enhancements of existing value chains/streams..
... such as software development, engineering, IT, and a wide variety of ... challenges and make educated trade-offs IT product manager, initially for a ... level leadership Leads cross-functional team,..
Description As a Data and Reporting Analyst, you will be responsible for generating reports and regular datasets for the Primary Care Organization (PCO) related to new patient growth. The Data and ..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... report information for end-users using system tools and database or data ... Medicaid Quality Data and Reporting..
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 The Healthcare Financial Analyst collects, analyzes, and reports on ... Central Region is seeking a Healthcare Financial Analyst to partner closely with our ... complex analytics and reporting. The..
