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Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description The Senior Quality Improvement Professional will focus organizational efforts on ... improvement. The Senior Quality Improvement Professional work assignments involve moderately complex ... Responsibilities The Senior Quality Improvement Professional..
Description The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional ..
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Description The Market Research Professional 2 performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Market Research Professional 2 work assignments are ..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, ... insurance. The Senior Provider Contracting Professional work assignments involve moderately complex ... USA) The Senior Provider Contracting Professional..
Description The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied ..
... a fit? Successfully navigating the healthcare industry and advancing our Integrated ... strategy to provide consumer-centric, integrated healthcare to help the millions of ... tackle the ambiguous world of..
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 ..
... Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, ... Senior Clinical Strategy and Practice Professional work assignments involve moderately complex ... Responsibilities The Senior Behavioral Health..
Description Quality Improvement Professional researches best business practices within ... will guide members through their healthcare journey, ensuring they receive the ... environment As a Quality Improvement Professional, you would..
Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Description The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work assignments are ..
Description The Care Management Support Professional 1 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Description The Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization Behavioral ..
Description The Care Management Support Professional 1 contributes to administration of ... members. The Care Management Support Professional 1 work assignments are often ... Specialist understands own work area professional..
... The Quality Compliance Nurse (RN) Professional uses quality improvement methodology to ... The Quality Compliance Nurse (RN) Professional leads quality improvement projects and ... The Quality Compliance Nurse (RN)..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the ..
... Senior Claims Research & Resolution Professional manages claims operations that involve ... Senior Claims Research & Resolution Professional work assignments involve moderately complex ... Senior Claims Research & Resolution..
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 ..
... The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge ... The Utilization Management Behavioral Health Professional 2 work assignments are varied ... The Utilization Management Behavioral Health..
Description The Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
Job Information Humana Provider Contracting Professional - Behavioral Health in Louisville Kentucky Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts and ..
