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Description The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other ..
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 ..
... career with BSI! Clinical Evaluation Specialist- Orthopaedic and Dental Remote working ... vacancy for a Clinical Evaluation Specialist within our Orthopaedic and Dental ... technologies. As a Clinical Evaluation..
We are currently searching for a Scientific Policy Analyst to support the mission of the Scientific Planning, Policy, and Analysis Branch of the National Institute of Arthritis and Musculoskeletal and Skin ..
Job Information Humana FP&A Lead, Medicaid Market in Bethesda Maryland Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
(This will open in a new window from which you will be automatically redirected to an external site after 5 seconds) Job Announcement This job opportunity is being re-announced. Applicants who ..
(This will open in a new window from which you will be automatically redirected to an external site after 5 seconds) Position Information The Circuit Court of Arlington County is seeking ..
Description Perform high quality exams in at least two of the following modalities: CT , MRI, DEXA, ULTRA SOUND, NUCLEAR MEDICINE, SPECIAL PRODECURES and DIAGNOSTIC IMAGING exams while providing excellent patient ..
... and landlords; When necessary, prepares documentation and testifies at hearings to ... Voucher Occupancy Public Housing Occupancy Specialist/Senior Specialist; Limited Income Housing Tax Credit ... Credit Housing Credit Certified..
... 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..
Description Job Description Summary 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 ..
... in court. Must maintain detailed documentation in an Electronic Health Record ... team to include Behavioral Health Specialist I, Behavioral Health Specialist II, Behavioral Health Senior Clinician, ... Treatment..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Bethesda Maryland Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Go the extra mile. Patients and Physicians rely on our diagnostic testing, information and services to help them make better healthcare decisions. These are often serious decisions with far reaching consequences, ..
Clinical Nurse Practitioner Job ID 2022-11421 # of Openings 1 Job Location(s) US-MD-Bethesda Posted Date 3 hours ago (1/20/2022 5:22 PM) Category Science, Research & Regulatory Overview We are currently searching ..
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 ..
... is looking for an experienced Healthcare Investigator to join its industry ... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... areas Bachelor's degree or significant..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Bethesda Maryland Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
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 ..
Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Bethesda Maryland Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and scope ..
Job Information Humana Medicare Appeals and Grievance Medical Director in Bethesda Maryland Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..