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The Ambulatory Care Nurse Manger is a working clinical manager with direct patient care responsibilities. He/she may be expected to perform the major duties/functions of Primary Care and Specialty Clinic registered ..
Job Information Kindred at Home LPN, Home Health Full Time in Beckley West Virginia As a Home Health LPN , you will: Provide professional nursing services under the direction of a ..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Charleston West Virginia Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..
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 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 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 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 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 Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
Description The CCM Compliance Professional 2 ensures compliance with governmental and contractual requirements. The CCM Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the ..
Description The Senior Security Professional protects the organization's employees, properties, and all items of value on premises from any preventable harm or danger. The Senior Security Professional work assignments involve moderately ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Charleston West Virginia Description Humana is looking for an experienced Healthcare Investigator to join its ..
Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. ..
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 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 ..
Job Information Centerwell Social Worker, Home Health in Beckley West Virginia The Medical Social Worker participates in the interdisciplinary care provided to home health patients. The Medical Social Worker functions to ..
Job Information Centerwell Licensed Practical Nurse Home Health Full Time in Charleston West Virginia As a H ome Health LPN , you will: Provide professional nursing services under the direction of ..
