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Job ID 21000L1TAvailable Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
... encounter inbound/outbound process issues, using data from internal and external sources ... outbound. Identify and interpret encounter data, submission requirements and performance metrics ... errors in systems/databases; perform encounter..
... leverages its advanced knowledge of data, modeling, optimization, and tools. Applies ... problems. Understands and analyzes complex data, articulates to various units within ... Bachelor's degree 2-5 years of..
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 ..
Job Information Humana Senior Provider Contracting Professional in Tallahassee Florida Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization ..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
... Information Humana Senior Corporate Strategy Analyst in Tallahassee Florida Description Humana's ... Responsibilities The Senior Corporate Strategy Analyst role is modeled after top-tier ... the analysis of situations or..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..
Description CarePlus is seeking a Clinical Business Lead who will lead teams of nurses and behavior health professionals responsible for Care Management and Utilization Management. The Clinical Business Lead works on ..
... the analysis of situations or data requires an in-depth evaluation of ... senior leaders with the right data to make informed strategic decisions ... by assessing qualitative and quantitative..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Tallahassee Florida Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Job Information Centerwell RN Clinical Manager in Tallahassee Florida The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, implements, analyzes, and organizes clinical ..
Description The Healthcare Financial Analyst collects, analyzes, and reports on ... and reports on various market data, connecting operational effectiveness and member ... Central Region is seeking a Healthcare Financial..
... The right candidate will make data-driven decisions, be an effective communicator, ... will evaluate new opportunities using data driven methodology to help prioritize ... of market findings rooted in..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable healthcare while keeping our provider networks ... Humana is seeking a Senior..
... the analysis of situations or data requires an in-depth evaluation of ... Florida market (contracts and gathering data for reports) Required Qualifications Bachelor's ... Work Experience (5 years of..
... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable healthcare while keeping our provider networks ... leverages their advanced knowledge of..
Description The Lead Cloud Architect leads the planning, design, and engineering of enterprise-level infrastructure and platforms related to cloud computing. The Lead Cloud Architect works on problems of diverse scope and ..
