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Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
Job ID 21000KHFAvailable Openings 1 PURPOSE AND SCOPE: Manages the provision of quality patient care in an independent home therapy program while maintaining cost-effective clinical operations in accordance with all legal, ..
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 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 Manages a team of coding educators and reports to Risk Adjustment Director. Responsible for implementing operational and clinical best practices in the risk adjustment methodology, understanding clinical suspects and appropriate ..
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 ..
n n Helpn n Requirementsn Conditions of Employmentn n You must be a U.S. citizen to apply for this jobn Subject to a background/suitability investigationn Designated and/or random drug testing may ..
Job Description & Requirements Dentist StartDate: ASAP Pay Rate: $87.00 - 99.00 Seeking a Dentist for locum tenens support as they look to fill a current need. Details & requirements for ..
Qualifications nn n To qualify for this position, you must meet the basic requirements as well as any additional requirements (if applicable) listed in the job announcement. Applicants pending the ..
Description Benefits Questions Position Overview About the Position Join our team and make a difference in preventing the spread of diseases in our jail system! As a Registered Nurse for the ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
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? ..
Job ID 21000M9XAvailable Openings 1PURPOSE 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 ..
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 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 ..
Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members ..
Internal Medicine or Family Medicine Physician (MD/DO)Glendale, AZ - Medical Clinic Group - Community HealthrnrnESSENTIAL DUTIES AND RESPONSIBILITIESrnrnDiagnoses and treats all patients presenting in both outpatient and inpatient settings while maintaining ..
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 ..
... appropriate courses of action. Humana Government Business government contract requires U.S. citizenship for ... care according to established Humana Government Business contractual requirements and guidelines. ... between all departments..
