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Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g. CPT) to patient records. The Medical Coding Auditor ..
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Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Job Information Humana Provider Contracting Professional in Newport Rhode Island Description The Provider Contracting Professional 2 Behavioral Health Network role; initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Job Information Humana Provider Contracting Professional - Behavioral Health in Newport Rhode Island Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts ..
Providing care as directed by a nursing supervisor, including but not limited to: bathing, grooming, oral care, dressing, undressing, toileting activities, taking and recording vital signs, and assisting with height and ..
Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Newport Rhode Island Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
Description The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or ..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..
Description The Pharmaceutical Manufacturer Relations Executive ensures the Pharmacy trade strategy aligns with formularies and the desired health outcomes of patients. The Pharmaceutical Manufacturer Relations Executive works on problems of diverse ..
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 Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
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 Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
Description Be a part of the CenterWell leadership team, a subsidiary whose purpose is to provide care management program support resources to physicians, physician groups, and integrated healthcare delivery systems throughout ..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
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 Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
Description The Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..
