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... customers Thought Leaders (TL) and Healthcare Providers (HCP) within assigned geography. ... Actively assess the medical and healthcare landscape by meeting with TLs/HCPs/access ... the competitive landscape and evolving..
Description The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied ..
Description The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work ..
Job ID 21000JNHAvailable Openings 1PURPOSE AND SCOPE: The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals’ policies and ..
PURPOSE AND SCOPE:Supports the training and education of employees based in company facilities and programs within an assigned geographical area. Delivers standardized, competency based, training and development programs including new employee ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work ..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Job Information Humana Provider Contracting Professional 2 - Remote Opportunity in San Juan Puerto Rico Description The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts ..
PURPOSE AND SCOPE:The professional registered nurse Inpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 ..
... Senior Provider Contracting Professional communicates contract terms, payment structures, and reimbursement ... and network administration in a healthcare company Experience in contract preparation and implementation Proficiency in ... and..
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, CPT) to patient records. The Medical Coding ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
PURPOSE AND SCOPE:The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals’ policies and procedures. Areas of practice are ..
Description The Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional work assignments are ..
Job Information Humana Staff Utilization Management Pharmacist/ Staff RX Clinical Programs /LT (Part Time Contract Position - Pharmacist - Remote, Puerto Rico in San Juan Puerto Rico Description The Staff Utilization ..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in San Juan Puerto Rico Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of ..
... The Provider Contracting Executive communicates contract terms, payment structures, and reimbursement ... settlement arrangements (with finance)Delivers a contract that can be operationalized, and ... be operationalized, and maintained.Collaborates with..
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 - Behavioral Health in San Juan Puerto Rico Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider ..