THE LARGEST COLLECTION OF HEALTHCARE JOBS ON EARTH
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... processing operations and systems. The Director, Claims Oversight plays a vital ... relate to claims. Responsibilities The Director, Claims Quality Audit will oversee ... exceptional results to the TRICARE..
... will report directly to the Director of Value-Based Strategies - CMS ... Bachelor's Degree 5 years in healthcare management, consultation, or similar role ... in Business, Public Health, or..
Description As the Director, Sales Product -Employer Group you will be responsible for defining and executing upon the sales product strategy & enablement plans across specific local markets and lines of ..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
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 Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... clinical delivery process. The Associate Director, Utilization Management..
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 ..
Description The Director of Health Services for National ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... the clinical delivery process. The Director of Health Services..
Description As the Associate Director, IT Project Management, you will ... your background and experience in program management to lead and manage ... our Medicare segment. The Associate Director is..
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 Our search is focused on identifying a certified coder who will primarily be responsible for conducting prospective and concurrent reviews to identify documentation improvement opportunities according to CMS and ICD-10 ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Phoenix Arizona ... Phoenix Arizona Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
FT/40hrs. This position is responsible for the training, support, and supervision of a team of Wraparound Facilitators, Child and Family Specialists, and Parent Partners. They are responsible for attending County Wraparound ..
Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
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 Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
Job Description $2000 Sign-On Bonus for qualified new hires! The Licensed Vocational Nurse (LVN)/ Licensed Practical Nurse (LPN) in expanded scope clinics is an integral part of the clinic team inside ..
Description The Director, Provider Reimbursement is responsible for ... team of associates. Responsibilities The Director, Provider Reimbursement develops and executes ... collaboration with other leaders, this Director will develop and..
... daily huddles Helps Regional Medical Director and Center Administrator in setting ... the local primary care 'on-call' program of CenterWell as needed Assures ... an accredited MD or DO..
FT/40 hrs. This position is responsible for supervising case managers and interns, training new case managers, and providing support and assistance to Case Managers. The Supervising Case Manager will also be ..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..
... Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving ... to supplement Humana's Health Assessment Program. The summary of the IHWA ... for necessary follow-up care. This..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
