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Description The Senior Stars Improvement, Clinical Professional (RN or LPN) responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars Program. The Senior Stars Improvement, Clinical Professional work ..
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Job Information Humana Manager, Behavioral Provider Contracting - Remote in Billings Montana Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and ..
Description The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work ..
... contract terms, payment structures, and reimbursement rates to providers. Providing a ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting ... contract terms,..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
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 The Senior Value-Based Programs Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Analyst works on problems ..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
Description The Large Group Medical Underwriter computes rates for both renewing and prospective moderate to complex group accounts. The Large Group Underwriter 2 work assignments are varied and frequently require interpretation ..
Description The Care Management Support Assistant 3 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 Director, Provider Reimbursement is responsible for the leadership, ... execution of Humana Military's provider reimbursement methodologies. This leader is responsible ... payment system software, and provider-specific reimbursement factors..
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 ..
... 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..
Job Information Humana Provider Contracting Professional - Behavioral Health in Billings Montana Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts and ..
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 Senior Value-Based Financial Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Professional works on problems ..
Description The Senior Nursing Educator plans, directs, coordinates, evaluates, develops, and/or delivers training and education programs for professional nursing personnel. The Senior Nursing Educator work assignments involve moderately complex to complex ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
Job Information Humana Provider Contracting Professional in Billings Montana Description The Provider Contracting Professional 2 Behavioral Health Network role; initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements ..
