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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 21000H48Available 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. ..
... 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..
... 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..
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 ..
... 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 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 ..
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). ..
Job ID 21000N5OAvailable 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. ..
... 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..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Winchester Virginia Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
