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Job Information Humana Manager, Behavioral Provider Contracting - Remote in Fargo North Dakota Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers ..
Description The Problem, Incident and Event Management Engineer 2 monitors trends in incidents and system issues and helps drive technical support teams to recover services during periods of service disruption or ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... administration determinations. The Manager, Utilization Management Nursing works within specific guidelines ... goals. Responsibilities The Manager, Utilization Management Nursing..
... care facility The Supervisor, Care Management Support will lead a team ... contributes to administration of care management. Provides non-clinical support to the ... of members. The Supervisor, Care..
... Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... and quality performance and staffing management. Detailed Responsibilities include: Leads Medicaid ... Medicaid operational process and workforce..
... the Associate Director, IT Project Management, you will use your background ... background and experience in program management to lead and manage a ... The Associate Director, IT Project..
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 ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral ... involves processing referrals into medical management system with emphasis on accuracy ... answer provider/beneficiary inquiries. The Care Management Support..
... Director, Problem, Incident and Event Management drives technical support teams to ... Director, Problem, Incident and Event Management requires a solid understanding of ... Director, Problem, Incident and Event..
... and possible participation in care management. The clinical scenarios predominantly arise ... health, or disease or care management. Medical Directors support Humana values, ... whether services provided by other..
... accounts and/or provider relations Associate management oversight of 3-5 direct reports ... 3-4 years of progressive network management experience including hospital contracting and ... and network administration in a..
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. ..
... purpose is to provide care management program support resources to physicians, ... physicians, physician groups, and integrated healthcare delivery systems throughout the country. Healthcare isn't just about health anymore...
Job Information Humana Telephonic Care Coach -WAH Nationwide in Fargo North Dakota Description The Care Coach 1, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or ..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills ... determinations. The Associate Director, Utilization Management Nursing requires a solid understanding ... process. The Associate Director, Utilization Management..
Description The Care Management Support Assistant 3 contributes to ... contributes to administration of care management. Provides non-clinical support to the ... wellbeing of members. The Care Management Support Assistant..
... accuracy of formularies and utilization management (UM) criteria in the Formulary ... Collaborates with other pharmacists and healthcare professionals in a team environment ... an expert in Humana's formulary..
Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
... 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..
Description The Utilization Management Behavioral Health Professional 2 utilizes ... benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... a Compact State The Utilization Management Behavioral Health..
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 ..
