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Job Information Humana Senior Contract Tools, Education, Processes Professional - ... South Carolina Description The Senior Contract Tools, Education, Processes Professional builds ... in class knowledge. The Senior Contract Tools,..
... analysis of data, and strategic contract performance improvement initiatives. Act as ... of specialty network contracts. Analyze contract performance and provide evaluation on ... existing contracts. Build and maintain..
Job Information Humana UM Medical Director - Conviva in Lancaster South Carolina Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
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 ..
... (1359) Quality/Risk Management (18) Type Contract (1) Fellowship (0) Full Time ... Full Time Days Mary Washington Healthcare Fredericksburg, Virginia NEW! NEW! Radiologic ... Michigan NEW! NEW! Radiology Interventional..
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 ..
Job Information Humana FP&A Lead, Medicaid Market in Lancaster South Carolina Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
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 ..
Admin / Clerical (197) Advanced Practice Registered Nurses / Physician Assistants (340) Allied Health (3222) Executive (80) Operations (255) Physicians/Surgeons (1359) Quality/Risk Management (18) Type Contract (1) Fellowship (0) Full Time ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Lancaster South Carolina Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare ..
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 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 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, ..
... 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..
Job Information Kindred at Home Healthcare Account Executive in Chesterfield South ... Carolina As a Home Health Specialist , you will: Call on ... line extensions and proposal or contract..
Hueman is hiring Nurse Practitioners to complete Health Risk Assessments (HRAs) in the home of Medicare and Medicaid members in and around Bluffton, SC. This position offers certified Nurse Practitioners the ..
Posted: 23-Feb-22 Location: Columbia, South Carolina Salary: Unpaid Categories: General Nursing Internal Number: 22001148_13 Description Registered Nurse Pediatric ICU AdventHealth for Children Up to $15,000 Sign-on Bonus and $5,000 Relocation available ..
