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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 ..
Description The Manager, Provider Contracting manages a team of dental recruiters that initiates, negotiates, and executes dental provider contracts and agreements in alignment with the specialty growth strategy. The manager provider ..
... & Waste to join the Provider Payment Integrity-Clinical Audit team working ... that our members receive quality healthcare at an affordable price. You ... (RN) license 3 years of..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Anchorage Alaska Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the ..
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 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 Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Description The Provider Contracting Professional 2 initiates, negotiates, ... initiates, negotiates, and executes dental provider contracts and agreements for an ... that provides health insurance. The Provider Contracting Professional 2..
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 Director, Provider Reimbursement is responsible for the ... and execution of Humana Military's provider reimbursement methodologies. This leader is ... prospective payment system software, and provider-specific reimbursement factors..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
Description The Senior Provider Engagement, Clinical Professional develops and ... relationships with physicians, providers and healthcare systems in order to support ... the health plan. The Senior Provider Engagement, Clinical..
Description The Provider Contracting Professional 2 initiates, negotiates, ... executes physician, hospital, and/or other provider contracts and agreements for an ... that provides health insurance. The Provider Contracting Professional 2..
Job Information Humana Provider Contracting Professional - Behavioral Health ... in Anchorage Alaska Description The Provider Contracting Professional 2 initiates, negotiates, ... health physician, hospital, and/or other provider contracts and..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..