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Description This is a salaried exempt position with responsibility for utilization management oversight and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in the TRICARE Operations Manual Chapter ..
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 Supervisor, Mail Operations Pharmacy Technician accurately fills and counts medications. The Supervisor, Mail Operations Pharmacy Technician works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of ..
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 ... San Antonio Texas Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Description The Supervisor, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Supervisor, Care Management works within thorough, prescribed guidelines and procedures; uses independent judgment ..
Job Information Humana Director, Informatics in San Antonio Texas Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights ..
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 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 Information Humana Supervisor, Medical Coding in San Antonio Texas Description The Supervisor, Medical Coding extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical ..
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 Manager of Fraud and Abuse Data Analytics in San Antonio Texas Description Responsibilities The Manager of Fraud and Abuse Data Analytics will be responsible for the supervision of ..
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 Supervisor, Credentialing in San Antonio Texas Description Responsibilities The Supervisor, Credentialing Operations is responsible for supervising activities associated with certification and recertification of providers in the TRICARE East ..
Posted: 28-Feb-22 Location: San Antonio, Texas Salary: Open Categories: General Nursing Nursing Internal Number: 2205003131 Up to $20,000 Sign-On bonus for experienced Registered Nurse / RN Summary The RN Shift Supervisor ..
Job ID 21000LVFAvailable Openings 1 PURPOSE AND SCOPE: Manages the provision of quality patient care in an independent home therapy program while maintaining cost-effective clinical operations in accordance with all legal, ..
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 ..
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 Supervisor, Medical Coding - San Antonio in San Antonio Texas Description The Supervisor, Medical Coding extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Job Information Humana Pharmacy Technician Supervisor - RxClinical Programs in San Antonio Texas Description The Supervisor, Rx Clinical Programs Pharmacy Technician supports Pharmacists and patients by executing programs developed to improve ..