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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 ..
Job ID 21000GDNAvailable Openings 3PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
... 40) market leader in integrated healthcare with a clearly defined purpose ... providing digital marketing funnel conversion support, enhancing SEO capabilities, and landing ... the moment of need for..
Job Information Humana Care Guide - Physical Health in Springfield Ohio Description The Care Guide (Care Coach 1) assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness ..
... to achieve quality standards.Provides leadership, support and guidance to facility management ... facility management including clinical and technical managers and other support. Provides informal feedback on an ... to..
Job Description Health is everything. At CVS Health, we are committed to increasing patient access to care, lowering costs and improving the quality of care. Millions of times a day, we're ..
... guidelines and procedures; applies advanced technical knowledge to solve moderately complex ... Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts ... their home. We are a..
Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..
Job Information Humana Provider Contracting Professional 2 - OH Medicaid in Springfield Ohio Description The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts under the Ohio Medicaid ..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
... the global leader in dialysis healthcare, we form bonds that enable ... camaraderie, emphasizing friendly collaboration, professional support, and career development. Superior training, ... for assigned patient(s). Perform all..
Job Information Humana Senior Provider Contracting Professional - OH Medicaid in Springfield Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts ..
... The Lead Cloud Architect performs technical planning, architecture development and modification ... 8 or more years of technical experience 2 or more years ... for complex business problems Prior..
... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable healthcare while keeping our provider networks ... on existing data related and..
... to meet schedules and/or resolve technical problems. Responsible for hiring, coaching ... disciplinary action and terminations. Provides technical guidance. Performs other related duties ... as assigned, and when necessary,..
Job ID 21000JZQAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
POSITION FEATURES:This is a full time RN for our surgery center in Moraine, OH.The center is open Monday through Friday 7:30am to 4:00pm. No eveings, weekends or Call.You will need 3+ ..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Springfield Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
