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... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... a Bachelor's degree in Business, Healthcare, or related field and/or 8 ... 5 years' experience in the..
Description The Accounting Lead performs general accounting activities, including the preparation, maintenance and reconciliation of ledger accounts and financial statements such as balance sheets, profit-and-loss statements and capital expenditure schedules. Conducts ..
Position Summary: Responsible for the delivery of patient care through the nursing process of assessment, nursing diagnosis, planning, implementation and evaluation. Is responsible for directing and coordinating nursing care for patients ..
... support advocacy efforts with state government officials and regulators (in partnership ... 5 or more years of healthcare policy experience including a track ... research, and resource development supporting..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
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 If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver exceptional ..
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 ..
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 Are you passionate about contributing to the well-being of the Medicare population? Are you looking for a role that will let your creative ideas, relationship management and sales ability shine? ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
n n Helpn n Requirementsn Conditions of Employmentn n n n ntU.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Description The DRG Validation 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 ..
Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..
**Providence is calling a Call Center Specialist (Food and Nutrition,** **Variable Shift, 0.0 FTE - On-Call as needed) to Providence Alaska Medical Center in Anchorage, Alaska.** **We are a community of ..
