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Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description The Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
Description The Medical Coding Auditor Supervisor handles a combination of tasks, including extracting clinical information from a variety of medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, ..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... Lancaster South Carolina Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Care Delivery Tele Sales Supervisor supports and develops a team of Care Delivery Tele Sales Agents. The Care Delivery Tele Sales Supervisor provides timely and effective support to assist ..
Job Information Humana Supervisor, Credentialing in Lancaster South Carolina Description Responsibilities The Supervisor, Credentialing Operations is responsible for supervising activities associated with certification and recertification of providers in the TRICARE East ..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Job Information Centerwell LPN Home Health Full Time in Monroe North Carolina As a Home Health LPN , you will: Provide professional nursing services under the direction of a RN in ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Job Details: This position will perform a variety of tasks to support the health and wellbeing of the plant staff including: operating the thermal temperature scanner and/or handheld thermal device as ..
Job Information Humana Director, Informatics in Lancaster South Carolina Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights ..
Description The Supervisor, Health Services Nursing serves as ... building out clinical capabilities. The Supervisor, Health Services Nursing oversees the ... or services for members. The Supervisor, coordinates and communicates..
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 ..
Job Information Centerwell LPN, Home Health Per Diem in Monroe North Carolina As a Home Health LPN , you will: Provide professional nursing services under the direction of a RN in ..
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 Humana Manager of Fraud and Abuse Data Analytics in Lancaster South Carolina Description Responsibilities The Manager of Fraud and Abuse Data Analytics will be responsible for the supervision of ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
Job Information Humana Referrals Coordinator 2 in Lancaster South Carolina Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied ..
Job Information Centerwell Physical Therapist Home Health Full Time in Monroe North Carolina As a Home Health Physical Therapist , you will: Plan and administer prescribed skilled physical therapy treatment and ..
