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Description The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs administrative/operational/customer support/computational tasks. Typically works within a framework ..
Description The Risk Adjustment Representative 3 works with regional provider offices to ensure timely submission of requested medical records that are submitted to the Centers for Medicare and Medicaid Services (CMS) ..
Customer Service Representative/Fitness Floor Specialist Bonnie & Donald Dwares JCC of the Jewish Alliance of Greater Rhode Island 401 Elmgrove Ave Providence, RI 02906 Principal Responsibilities: The Customer Service Representative/Fitness Center ..
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 AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Newport Rhode Island Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to ..
Job Information Humana Manager, Fraud and Waste-Remote US in Newport Rhode Island Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
Description If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver exceptional ..
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). ..
Description The Senior Coding Educator identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Senior Coding Educator work assignments involve moderately complex to ..
Description Are you passionate about contributing to the well-being of the Medicare population? Are you looking for a role that will let your creative ideas, relationship management and sales ability shine? ..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..
Description The Senior Professional collaborates with healthcare professionals, pharmacists, and other business functions to implement formulary and medical strategies for the Medicaid line of business. Makes decisions on moderately complex to ..
Job Information Humana AVP, Stars and Risk Adjustment National Medical Director in Newport Rhode Island Description The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking a talented Physician executive that ..
Description Responsibilities If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver ..
Job Information Humana UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Newport Rhode Island Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, DME, ..
Description The Senior Value-Based Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Analyst works on problems of diverse ..
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 ..
POSITION FEATURES:Acute Dialysis RN to support the following hospitals: Landmark and Roger Williams2021 and 2022 America's 'Most Loved Workplaces' by NewsweekNo prior RN dialysis experience required; 12 weeks of paid & ..
Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members ..
