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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, ..
Job Information Humana Director, Informatics in Metairie Louisiana Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..
Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..
Job Information Humana Senior Technology Implementation Professional (Remote-Nationwide) in Metairie Louisiana Description The Senior Technology Implementation Professional delivers new technological solutions to meet business needs within a specified scope while aligned ..
Description The Referrals Coordinator 2 processes referrals from Civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Typically works on semi-routine assignments. Responsibilities The Referrals ..
WalgreensnJob DescriptionWhere state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience. Serves as a full-time certified pharmacy ..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Metairie Louisiana Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Job Information Humana Care Management Supervisor (Prescription Assistance Program)- CenterWell-Remote in Metairie Louisiana Description The Supervisor, Care Management leads teams of health professionals responsible for assessing and evaluating patient's needs and ..
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 ..
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 ..
RN—ClinicalAbout this role: As a Dialysis Clinic Registered Nurse (RN) with Fresenius Medical Care, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing ..
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 ..
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 ..
PURPOSE AND SCOPE:Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with ..
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 Responsibilities The Senior Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. Translates business needs into technical systems solutions. Integrates ..
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 ..
