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Position OverviewThe HSC Specialist provides third level service support and knowledge transfer to the Siemens Healthcare Regional Units and business partners worldwide. This position reports to the HSC Manager within ..
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Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for claims reserve valuation, financial forecasting, and strategic and operational decisions within ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
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 21000AEOAvailable Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions ..
Description The Actuary, Analytics/Forecasting will develop the financial forecast for the dental and vision benefits included within Humana's growing Medicare Advantage business, as well as pricing and oversight of other stand ..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Dover Delaware Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese and ..
Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates new product ideas, enhance existing products or strategic product extensions, and translates research discoveries into marketable products. This ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description Get your foot in the door with this Entry-Level Training Ground Inside Sales Executive position! Enjoy a fast paced dynamic environment that offers a variety of responsibilities and assignments centered ..
Description The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 work assignments are varied and frequently ..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
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 ..
