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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 ..
Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Naples Florida Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
... seeking an Associate Director, Care Management who will lead teams of ... health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding of .....
... consultation in palliative care, symptom management and supportive care to meet ... Assist with diagnosis, treatment and management of acute and chronic health ... patient education, care planning and..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Naples Florida Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..
... concepts to test Participates in vendor contract planning and implementing new ... or more years of product management experience and/or clinical implementation Leadership ... and Outlook Excellent organizational, time..
Job Information Humana Senior Provider Contracting Professional in Naples Florida Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts. The Senior Provider Contracting Professional ..
Description Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... administration determinations. The Manager, Utilization Management Nursing works within specific guidelines ... we succeed! The Manager, Utilization Management Nursing..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Description The Care Management Support Assistant 2 contributes to ... contributes to administration of Care Management. Provides non-clinical support to the ... for well-being Responsibilities The Care Management Support Assistant..
Job Information Humana OB Care Management Support Assistant 2/Medicaid (Bilingual English/Spanish ... Naples Florida Description The Care Management Support Assistant 2 contributes to ... contributes to administration of care management...
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Naples Florida Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Job Information Humana Clinical Vendor Management Lead - Remote, FL in ... Naples Florida Description The Clinical Vendor Management Lead works as clinical liaison ... vendors and organization. The Clinical..
... health professionals responsible for Care Management and Utilization Management. The Clinical Business Lead works ... Humana systems and capabilities. Program Management experience PMP/PMI certification. Independent with ... and value..
... field Prior experience with corporate management over direct reports Prior health ... verbal Strong organizational and project management skills For this job, associates ... done through an approved Humana..
... seeking an Associate Director, Care Management leads teams of nurses and ... health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding of .....
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Naples Florida Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
