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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 CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
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 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 ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Meridian Idaho Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..
**Company :**Highmark Inc.**Job Description :****JOB SUMMARY**This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA and ACA), using skills including but not ..
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 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 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 ..
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 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 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 ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Meridian Idaho Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
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, ..
Job Information Humana Care Manager, Telephonic Nurse 2 Certified Diabetes Care and Education Specialist-Remote-US in Meridian Idaho Description The Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless nursing ..
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 ..
Posted: 25-Feb-22 Location: Boise, Idaho Salary: Open Categories: General Nursing Internal Number: 51423 St. Lukes Health System is currently seeking a Clinical Nurse Specialist (CNS) for Adult Health Services to join ..
