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... Value-Based Strategies -- CMS Programs Provider Engagement Lead in Honolulu Hawaii ... Value-Based Strategies - CMS Programs Provider Engagement Lead will support Humana ... Value-Based Strategies - CMS Programs..
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 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..
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 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 Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
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 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 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 Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of a ..
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 ..
Job Information Humana Provider Contracting Professional - Behavioral Health ... in Honolulu Hawaii Description The Provider Contracting Professional 2 initiates, negotiates, ... health physician, hospital, and/or other provider contracts and..
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 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..
... & 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..
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..
