THE LARGEST COLLECTION OF HEALTHCARE JOBS ON EARTH
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IT Healthcare Business Analyst * Greenwood Village, CO Long ... to national accounts. The Business Analyst will have the following responsibilities: ... Create, maintain and manage systems documentation defining business..
... to appropriateness of hospitalization, clinical documentation, continued inpatient stay, and use ... inpatient stay, and use of healthcare resources. The PA further acts ... physician cooperation and understanding of..
... to:u003c/strongu003e perform audits of the documentation and posted CPT, HCPCs and ... billed and supported by the documentation in the clinical medical record. ... ensure improved accuracy of billing/coding..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... for a Senior Business Systems Analyst to join working remote anywhere ... US! The Senior Business Systems Analyst performs analysis of business, process ... business, process and user needs,..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..
... with operational areas to prepare documentation and files for presentation to ... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the ..
... and concurrent reviews to identify documentation improvement opportunities according to CMS ... clinical suspects and appropriate clinical documentation and accurate coding. Candidate MUST ... for identifying the impact of..
... health. Dedicated to simplifying the healthcare experience and helping people navigate ... and helping people navigate their healthcare journey, Author is leveraging digital ... a new path for the..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..
... clinical suspects and appropriate clinical documentation and accurate coding. This role ... adjustment methodology gained from HCC documentation, coding and provider education experience. ... result in improved accuracy of..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description The Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..
Description Come join the Digital Health & Analytics (DH&A) team within Humana to build a world class Data Science and Insights enterprise capability leveraging digital-first platforms, analytics, and agile development methodologies. ..
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 Actuary, SPA RX will be mainly responsible for supporting the pricing work related to our standalone Prescription Drug Plans (PDPs). This includes both bid development and reforecasts throughout ..
... and terms. Maintains contracts and documentation within a tracking system. May ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting ... in the..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... Medicaid Quality Data and Reporting Analyst will be responsible for the ... including the design, development, testing,..
