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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 Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. As ... a whole. As a senior-focused healthcare provider, and subsidiary of..
Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Description The Compliance (UM) Lead conducts and summarizes compliance audits. The Compliance (UM) Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities The Compliance (UM) ..
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 Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. Responsibilities ... Maintains referral records and files documentation. Responds to patient inquiries..
Job Information Humana Physician - CenterWell - Atlanta, GA in Tampa Florida Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical ..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
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 ..
Description The Senior Clinical Pharmacy Advisor - Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high performing team that helps ..
Summary Planned Giving Bequest Administration Specialist Position Highlights: The Planned Giving ... The Planned Giving Bequest Administration Specialist plays a key role in ... and other third-party representatives. The Specialist..
Description The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse ..
Description The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high ..
Description The Supervisor, Utilization Management will lead a team of Utilization Coordinators that supports the Prior Authorization team for the Florida Medicaid market. The Supervisor will lead a team on non-clinical ..
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 At Conviva Care Solutions, we want to inspire people to live life their best healthy life. Conviva Care Solutions is a management services organization representing nearly 300 physician practices, 800 ..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in Tampa Florida Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a ..
Job Information Humana Actuary, Risk and Compliance in Tampa Florida Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..
