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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 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 Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Job ID 21000MNQAvailable Openings 1DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient’s future—as well as your own. Connect with ..
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 ..
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 ..
... in large, complex, and integrated healthcare or payer setting Experience in ... or payer setting Experience in healthcare management and/or operations, Provider Practice/Healthcare or medical center operations Ability .....
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Performance Improvement Consultant - Healthcare Revenue Cycle Services Overview of ... cross-functional teams. The Performance Improvement Specialist will be responsible for monitoring ... management and internal / external resource teams..
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 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 ..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
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 Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
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 The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
... 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..
