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The Health Plan is seeking a Claims Department Manager to provide directional change, guidance, and assistance to the department Supervisors.Responsibilities Include:Managing the Health Plan's activities in the area of claims processing, ..
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Description The Director, Provider Contracting initiates, negotiates, and executes physician, ... health insurance. The Director, Provider Contracting requires an in-depth understanding of ... segment. Responsibilities This Director, Provider Contracting will..
If you're reading this job posting, you are ready to make a change. We'd love to have you join our team! We share the same passion of caring for others. With ..
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 Provider Contracting Executive initiates, negotiates, and executes ... provides health insurance. The Provider Contracting Executive works on problems of ... to substantial. Responsibilities The Provider Contracting Executive communicates..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes ... health insurance. The Senior Provider Contracting Professional work assignments involve moderately ... factors. Responsibilities The Senior Provider Contracting Professional..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, ... segment. Responsibilities The Director, Provider Contracting- Behavioral Health Medicaid communicates contract ... Degree 5 plus years provider contracting experience,..
Description The Associate VP of Payment Innovation supports the creation of new value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Associate VP of ..
Description The Provider Contracting Professional 2 initiates, negotiates, and ... provides health insurance. The Provider Contracting Professional 2 work assignments are ... of action. Responsibilities The Provider Contracting Professional 2..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
... Information Humana Manager, Behavioral Provider Contracting - Remote in Bethesda Maryland ... Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, ... Manager, of Behavioral Health Provider..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..
Job Information Humana Provider Contracting Professional in Bethesda Maryland Description ... Bethesda Maryland Description The Provider Contracting Professional 2 Behavioral Health Network ... agreements to include Medicare gap closing/contracting Responsibilities..
Description The Hospital Contracting Executive initiates, negotiates, and executes ... provides health insurance. The Hospital Contracting Executive works on problems of ... to substantial. Responsibilities The Hospital Contracting Executive communicates..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and ... segment. Responsibilities The Director, Provider Contracting- Behavioral Health communicates contract terms, ... Degree 5 plus years provider contracting experience,..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes ... health insurance. The Senior Provider Contracting Professional work assignments involve moderately ... (anywhere USA) The Senior Provider Contracting Professional..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
Job Information Humana Provider Contracting Professional - Behavioral Health in Bethesda Maryland Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts and ..
