Manager Healthcare Payer Jobs in Falmouth

... acumen to solve for the healthcare challenges of today. The Clinical ... low value care and related healthcare resource waste, with a focus ... news and reports in the..

... Clinical Analytics and Trend Program Manager in Portland Maine Description The ... Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... Minimum 2 years working in..

... 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..

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 ..

... (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..

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

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 ..

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

Job Information Centerwell Physical Therapist Home Health Full Time in Brunswick Maine As a Home Health Physical Therapist , you will: Plan and administer prescribed skilled physical therapy treatment and training ..

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

... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..

Job Information Genesis Healthcare Marketing and Admissions Director in ... discharge planners to maximize referrals.Genesis HealthCare is a leading provider of ... is a leading provider of healthcare services from..

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

Description Responsibilities 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 ..

... as directed by the Clinical Manager. Confer with physician in developing ... with physician orders, under Clinical Manager's supervision. Revise plan in consultation ... Coordinate appropriate care, encompassing various..

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 ..

Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates new product ideas, enhance existing products or strategic product extensions, and translates research discoveries into marketable products. This ..

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

Locums Psych (MD/DO) need in Maine (southern)u2013tBC preferredu2013tFloat between 3 facilities (one facility will consider telehealth)u2013tASAP (thru April 15, possible extension)u2013tO/P addiction medicineu2013t2 days/weeku2013tAvg 10-20 (depending on type of appt)u2013tSuboxone u2013 ..

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 ..

Genesis HealthCare is one of the leading ... of the leading providers of healthcare services from short-term to long-term ... *Learn the characteristics of each payer source, and the implications..

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 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..