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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 Senior Technology Implementation Professional (Remote-Nationwide) in Springfield Missouri Description The Senior Technology Implementation Professional delivers new technological solutions to meet business needs within a specified scope while aligned ..
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 ..
Job Information Humana Care Management Supervisor (Prescription Assistance Program)- CenterWell-Remote in Springfield Missouri Description The Supervisor, Care Management leads teams of health professionals responsible for assessing and evaluating patient's needs and ..
... or observations to the nurse supervisor. Evaluate vascular access for patency ... any unusual findings to nurse supervisor. Obtain necessary pre and post ... Report unusual findings to nurse..
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 ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Job Information Centerwell Physical Therapist, Home Health Full Time in Springfield Missouri As a Home Health Physical Therapist , you will: Plan and administer prescribed skilled physical therapy treatment and training ..
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 Kindred at Home Occupational Therapist Assistant, Home Health Full Time in SPRINGFIELD Missouri As a Home Health Occupational Therapist Assistant , you will: Provide therapy services planned, delegated and ..
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 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 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 ..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Springfield Missouri Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Job Information Humana Director, Informatics in Springfield Missouri 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 Learning Facilitation Professional 2 (LFP2) plans, coordinates, conducts or facilitates learning experiences for Humana Military associates and/or external audiences. The LFP2 creates an environment that is conducive to learning ..
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 ..
Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..
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 ..
