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... look for a Senior Business Systems Analyst to join working remote ... the US! The Senior Business Systems Analyst performs analysis of business, ... requirement specifications. The Senior Business..
... take charge of their own healthcare decisions. Provide guidance and clinical ... coordinate interventions that may include information, education, resources and referrals Coordinate ... learn how to use virtual..
... physicians, physician groups, and integrated healthcare delivery systems throughout the country. Healthcare isn't just about health anymore. ... of our members, and the healthcare industry as a whole. Responsibilities..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..
... phone to gather additional clinical information or discuss determinations regularly, and ... whether services provided by other healthcare professionals are in agreement with ... management organizations, hospitals/ Integrated Delivery..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
... Facility to obtain sufficient clinical information for all levels of facility ... operations experience Knowledge of Humana systems and clinical programs Additional Information Interview Format As part of .....
Job ID 21000FNSAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Clinical Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also pulls ..
Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
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, ..
Level Experienced Job Location NH MST - Manchester - Manchester, NH Position Type Full Time Education Level Masters Degree Travel Percentage Up to 50% Job Shift Various Shift Hours Job Category ..
Job ID 21000IOOAvailable Openings 2PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Senior Product Manager conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of ..
... get the right care and information based on their specific condition ... related experience in management of healthcare analytical support staff Technical proficiency ... for optimal performance from Humana..
... phone to gather additional clinical information or discuss determinations regularly, and ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
Level Experienced Job Location NH MST - Manchester - Manchester, NH Position Type Full Time Education Level Bachelors Degree Travel Percentage Up to 50% Job Shift Various Shift Hours Job Category ..
... safety of the facility water systems, as allowed by local regulations. ... FMS business policies, procedures and systems are incorporated into training, including ... 160. Record accurate and timely..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
Job ID 21000IBMAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Job Location NH MST - Nashua - Nashua, NH Position Type Full Time Education Level Bachelors Degree Travel Percentage Up to 50% Job Shift Various Shift Hours Job Category Nonprofit - ..
... can complete or request additional information. Role Responsibilities Recognizes specific assessments/treatment ... civilian providers to obtain additional information that may be required to ... Processing) . Two years prior..
