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Company Name: Kroger Specialty Pharmacy Position Type: Employee FLSA Status: Non-Exempt POSITION SUMMARY Perform duties to assist patients with access to benefits and co-pay cards, and schedule delivery of prescriptions provided ..
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Job Information Humana Senior Contract Tools, Education, Processes Professional - ... Metairie Louisiana Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..
Job Information Humana Medicare Appeals and Grievance Medical Director in Metairie Louisiana Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
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 ..
... compliance issues Work with the Contract Compliance Officer and Compliance Officer ... designed to resolve LDH FWA contract compliance issues Respond to FWA ... meetings Required Qualifications Experience in..
... market contracting teams to influence specialist contract terms that align with Service ... in close coordination with PCP Contract Load, Capitation Rates, Payments, and ... Adjustments teams to ensure..
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 ..
Job Information Humana FP&A Lead, Medicaid Market in Metairie Louisiana Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..
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 ..
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 Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..