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... happen. Responsibilities The Senior Provider Contracting Professional initiates, negotiates, and executes ... health insurance. The Senior Provider Contracting Professional work assignments involve moderately ... variable factors. The Senior Provider..
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Description The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work ..
Description The Provider Contracting Professional 2 initiates, negotiates, and ... provides health insurance. The Provider Contracting Professional 2 work assignments are ... action. Responsibilities Role Overview Provider Contracting Professional 2..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in San Antonio Texas Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
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 ..
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 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 Responsibilities The Market Development Advisor oversees the implementation and operations of the TRICARE contract in smaller multi-city geographic areas. You will have multiple Humana Contract Offices (HCOs) under your supervision ..
Description The Network Operations Coordinator 3 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. The Network Operations ..
... Information Humana Manager, Behavioral Provider Contracting - Remote in San Antonio ... Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, ... Manager, of Behavioral Health Provider..
Job Information Humana Provider Contracting Professional in San Antonio Texas ... Antonio Texas Description The Provider Contracting Professional 2 Behavioral Health Network ... agreements to include Medicare gap closing/contracting Responsibilities..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
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 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 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 ..
... will be responsible for identifying, contracting and onboarding Home Health agencies ... administrative owner of the agency contracting and onboarding process. This person ... Administration support experience in a..
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 Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
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 ..
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 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 ..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Job Information Humana Provider Contracting Professional - Behavioral Health in San Antonio Texas Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts ..
