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Description The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
Description The Medical Record Retrieval Specialist (Risk Adjustment Representative) travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding ..
... with senior leadership such as program updates, and market event notifications ... care, medical billing and clinical program development to drive efficiencies in ... to drive efficiencies in the..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
... Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Glen Allen Virginia ... implementation and ongoing management of program initiatives. Works holistically with internal ... holistically with internal and external..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
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 ..
Job Information Humana Market President AVP - Virginia in Richmond Virginia Description Most competitive candidates will reside in the market (Tidewater or Richmond, VA) Reporting structure: Reports into Cheri Greenfield-LaTour, SVP ..
... the global leader in dialysis healthcare, we form bonds that enable ... exceptional benefits. Outstanding tuition reimbursement program. Recognized among Fortune’s “World’s Most ... Adheres to the FMCNA Compliance..
OrthoVirginia, Virginia's largest provider of expert orthopedic and therapy care, is currently seeking a full-time, licensed Physician Assistant (PA) to join our team! This position is under Dr. Joshua Herzog. Along ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Job ID 21000LYEAvailable Openings 1Position Specific Information Richmond South location - Ricmond, VA Dialysis experience is required RN license is required PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer ..
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 ..
... Certified Diabetes Care and Education Specialist-Remote-US in Glen Allen Virginia Description ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..
Description Humana's Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 175 centers across eight states under two ..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Glen Allen Virginia Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing ..
... to improve the quality of healthcare for humanity. All full-time university ... here: https://hr.vcu.edu/current-employees/benefits/university-and-academic-professional-benefits/ Summary The Grant Specialist (Specialist) assists the grants administrator in ... administration of sponsored project...
Job Information Humana FP&A Lead, Medicaid Market in Glen Allen Virginia Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
Oncology Business Specialist -- Richmond, VA Do you want to be part of a team that works every day to develop innovative therapies for patients? Do you want to be part ..
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 Area Medical Director serves as a health-care professional and capable of handling a variety of health-related problems. The Associate Medical Director requires a solid understanding of how organization capabilities ..
