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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
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 ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description Job Description Summary 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 ..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Portland Maine Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special Investigations ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Portland Maine Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
Job DescriptionnPersonal Support Specialist (PSS) - Per Diem - Falmouth, ME Shifts Available: All ShiftsSetting: Long-Term Care nMAS Medical Staffing is currently seeking a Personal Support Specialist for a great opportunity ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
$5,000 Sign-on Bonus - Limited Time Genesis HealthCare is one of the nation's leading providers of healthcare services from short-term to long-term care and a wide variety of living options and ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Job DescriptionnPersonal Support Specialist (PSS) - Per Diem - Portland, ME Shifts Available: All ShiftsSetting: Assisted Living nMAS Medical Staffing is currently seeking a Personal Support Specialist for a great opportunity ..
Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
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 Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..
Job Information Centerwell Healthcare Account Executive in Kennebunk Maine As a Home Health Specialist , you will: Call on physicians, hospitals, skilled nursing facilities’ management, discharge planners, and case managers within ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Job Information Centerwell Occupational Therapist Home Health PRN in Kennebunk Maine As a Home Health Occupational Therapist , you will: Assess/screen patient's daily living/work-related skills and develop therapeutic retraining programs with ..
