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Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Analyst works on problems ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..
Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... leadership and external exposure with healthcare providers in OH,..
Job Information Humana Provider Contracting Professional 2 - OH Medicaid in Toledo Ohio Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts under the Ohio Medicaid ..
Description The Physician Performance Insights team's mission is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain high quality ..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Toledo Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Job Information Humana Senior Provider Contracting Professional - OH Medicaid in Toledo Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..
Job Information Humana Contract Tools, Education, Processes Professional - Louisville, KY or Remote (EST hours) in Toledo Ohio Description The Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and ..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description The Care Management Support Assistant 2 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 ..
Job Information Humana Manager, Fraud and Waste-Remote US in Toledo Ohio Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Toledo Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Toledo Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Toledo Ohio Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..
