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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..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in ... Morgantown West Virginia Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records..
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 ..
... support the coordination, documentation and communication of medical services and/or benefit administration determinations. ... Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking ... solve independently Strong..
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. ..
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,..
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 ..
FULL TIME POSITION Genesis Rehab Services is a leading provider of Physical, Occupational, Speech and Respiratory Therapy for older adults in skilled nursing facilities, independent and assisted living communities, CCRCs, Transitional ..
Job Information Humana Quality Improvement Coordinator in Morgantown West Virginia Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. ..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Morgantown West Virginia Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts ..
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 ..
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 ..
Job Information Humana Manager, Fraud and Waste-Remote US in Morgantown West Virginia Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
Job Information Humana Contract Tools, Education, Processes Professional - Louisville, KY or Remote (EST hours) in Morgantown West Virginia Description The Contract Tools, Education, Processes Professional builds templates, standard documentation, policy ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in ... Morgantown West Virginia Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records..
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 Inpatient Medical Coding Auditor-Remote/Virtual in US in ... Morgantown West Virginia Description The Medical Coding Auditor extracts clinical information ... information from a variety of medical records..