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Description Responsibilities The ACD Referral Authorization Coordinator Lead role will assist the Supervisor in oversight & monitoring of processing and timeliness standards for referrals and authorizations under the Autism Care Demonstration ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
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 ..
The Vocational Rehabilitation Counselors (VRCs) are located in the Veterans Benefits Administration (VBA) Regional Office (RO), RO Out based office location, Vet Success On Campus (VSOC) school site, or Integrated Disability ..
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 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 ..
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 ..
The Emory University School of Medicine, Department of Gynecology and Obstetrics, is recruiting a full-time Epidemiologist/Health Services Researcher. The position will hold a rank of Assistant Professor, Associate Professor or Professor, ..
Atlanta Polsinelli has one of the largest health care practices in the U.S. with 23 offices and is currently seeking a health care litigation associate to join our national health care ..
Job Information Humana Bilingual Quality Auditor in Atlanta Georgia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
Senior Occupational Health ManagerAt Pilgrimu2019s, Safety Is A Condition, which means the safety of our team members comes first - always.We have implemented safety measures to prevent the spread of COVID-19. ..
Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST states Responsibilities The Bilingual Grievances ..
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 ..
Qualifications nn n Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.nnBasic Requirements:nntUnited States ..
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 ..
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 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 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 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? ..
Airport Concessions Manager Airport Concessions Manager - Compliance General Description and Classification Standards Manages tenant contractual obligations and operational aspects of concession tenants. This is an experienced managerial level charged with ..