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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 ..
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 ..
Job Information Humana Manager, Pharmacy and Medical Trend in Anchorage Alaska Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and medical, ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
... looking for an experienced Senior Healthcare Investigator to join its industry ... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... Qualifications Bachelor's degree or significant..
Job Information Humana Clinical Pharmacy Lead, Remote in Anchorage Alaska Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..
**Providence is calling a Call Center Specialist (Food and Nutrition,** **Variable Shift, 0.0 FTE - On-Call as needed) to Providence Alaska Medical Center in Anchorage, Alaska.** **We are a community of ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Anchorage Alaska Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Anchorage Alaska Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
... Certified Diabetes Care and Education Specialist-Remote-US in Anchorage Alaska Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
... Processes Professional builds templates, standard documentation, policy and protocol, case studies, ... Qualifications Bachelor's Degree in Business, Healthcare Administration, Mathematics and/or related field ... implementation technical experience Medicaid experience..
... of coding practices and clinical documentation, grievance and appeals processes, and ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
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 ..
Job Information Humana Medical Director - S. Florida in Anchorage Alaska Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
**Providence is calling a CAT Scan Technologist ( Radiology,Day-Shift, 1.0 FTE) to St Elias Specialty Hospital in Anchorage, Alaska. We are a community of caregivers delivering every day on our Mission ..
Job Information Humana FP&A Lead, Medicaid Market in Anchorage Alaska Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Anchorage Alaska Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
**Providence is calling a Clinical Laboratory Assistant Outreach (Lab Outreach Admin, Variable** **Shift, 1.0 FTE - 40 hours per week) to Providence Alaska Medical Center in Anchorage, Alaska.** **We are a ..
