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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 ..
... audit/validation processes to ensure that medical record documentation and diagnosis coding ... and investigating clinical/coding information, researching medical materials and sources in order ... audit/validation process to ensure that..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 ... verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are ... Where you Come In The..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Columbia Tennessee Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Clinical Implementation Consultant At Kindred, we're dedicated to hope, healing and recovery. As the nation's largest specialty care hospital company, we care for people recovering from illness or injury - compassionately ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in ... in Columbia Tennessee Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records..
Description The Physician Performance Insights team's mission is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain high quality ..
Job Information Humana Manager, Fraud and Waste-Remote US in Columbia Tennessee Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
... relationships through effective and timely communication. Takes initiative and action to ... confidentiality at all times Excellent communication skills, both verbal and written. ... a working knowledge of standard..
Job Information Humana Quality Improvement Coordinator in Columbia Tennessee Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The ..
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 Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in ... in Columbia Tennessee Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records..
... with related parties for all communication with patients regarding prescription issues ... related experience. Excellent customer service, communication, organizational and interpersonal skills required. ... philosophy. Excellent written and verbal..
Job Information Humana Contract Tools, Education, Processes Professional - Louisville, KY or Remote (EST hours) in Columbia Tennessee Description The Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and ..
Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM,..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in ... in Columbia Tennessee Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records..
PURPOSE AND SCOPE: The Credentialing Specialist is responsible for verifying submitted Credentialing documentation. for all specialties that provide services to the organization's members. The Credentialing Specialist incumbent will meet all credentialing ..
Description The Healthcare Financial Analyst collects, analyzes, and reports on various market data, connecting operational effectiveness and member experience to financial outcomes. Responsibilities The East Central Region is seeking a Healthcare ..
