Manager Healthcare Payer Jobs

Description Be a part of the eBusiness team, drivers of provider self-service adoption through education and promotion of electronic transactions the Availity secure provider portal, Watson Voice, EDI, etc. As a ..

Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..

Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..

Job Information Humana Manager, Fraud and Waste-Remote US in ... Colorado Springs Colorado Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..

... of the MRA team, the Manager will work closely with market ... based on advanced knowledge/experience. The Manager, Risk Adjustment works within specific ... approach, resources, schedules and goals.The..

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). ..

Job Information Humana Oncology Market Director in Colorado Springs Colorado Description The Market Director, Oncology leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions to ..

Job Information Genesis Healthcare Marketing and Admissions Director in ... in Colorado Springs Colorado Genesis HealthCare is the nation's leading provider ... the nation's leading provider of healthcare services from..

Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..

Job Information Humana Manager, Utilization Management RN - Remote ... Colorado Springs Colorado Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management..

... Clinical Analytics and Trend Program Manager in Colorado Springs Colorado Description ... Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... Minimum 2 years working in..

Description The Manager, Medical Coding oversees the coding team that is reviewing inpatient records for appropriate coding to include ICD-10, CPT, and HCPCS. The Manager, Medical Coding works within specific guidelines ..

Job Information Humana Product Manager Lead, Pharmacy Transformative Products Team, ... 60 market leader in integrated healthcare with a clearly defined purpose ... us redefine the future of healthcare. With..

Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in Colorado Springs Colorado Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and ..

... acumen to solve for the healthcare challenges of today. The Clinical ... anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... years or more working in..

... (CCM) organization is seeking a Manager, Fraud & Waste to join ... As the Fraud & Waste Manager at Humana, you will support ... that our members receive quality..

Description Humana Medicaid is growing and you have the unique opportunity to grow with us! Join our team and propel Humana forward to solve the technology challenges of tomorrow. You'll collaborate ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Job Information Humana Lead Product Manager - Healthcare API in Colorado Springs Colorado ... Colorado Description The Lead Product Manager - Healthcare API (SME) as part of ... Individual will..

Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..

SCOPE The Behavioral Health Clinical Director is primarily responsible for leading and directing the organizations medically necessary services that are referred to the organization. This position will supervise the Behavioral Health ..

Welcome to Centura Health:At Centura Health, we're on a mission to heal individuals and uplift communities.  We have locations throughout Colorado, Utah, and western Kansas, giving you opportunity to grow your ..

Description The Behavioral Health Care Manager, Telephonic Nurse, in a telephonic ... wellbeing of members. The Care Manager, Telephonic Nurse work assignments are ... seeking a Behavioral Health Care Manager..