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Description The Senior Provider Engagement Dedicated Care Manager develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within ..
... monitors trends in incidents and system issues and helps drive technical ... technology platforms / applications, performs system analysis and translates into system requirements. The work assignments are .....
... for a Senior Business Systems Analyst to join working remote anywhere ... US! The Senior Business Systems Analyst performs analysis of business, process ... analysis and translation into proper..
... for leading interaction with our IT partners to ensure a clear, ... consultant to an agency, vendor, IT, digital and communications teams to ... update our documentation library with..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the ..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records, and reviews medical documentation for clinical indicators to ensure specific procedures meet clinical criteria and correct coding ..
Description The Market Development Professional 2 provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Market Development ..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
... and documentation within a tracking system. May assist with identifying and ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting experience ... in..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... report information for end-users using system tools and database or data ... Medicaid Quality Data and Reporting..
Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..
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 ..
... such as software development, engineering, IT, and a wide variety of ... challenges and make educated trade-offs IT product manager, initially for a ... level leadership Leads cross-functional team,..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
... Humana Lead Product Manager - Healthcare API in Glen Allen Virginia ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
Description As a Data and Reporting Analyst, you will be responsible for generating reports and regular datasets for the Primary Care Organization (PCO) related to new patient growth. The Data and ..
Description The Healthcare Financial Analyst collects, analyzes, and reports on ... Central Region is seeking a Healthcare Financial Analyst to partner closely with our ... complex analytics and reporting. The..
... streams and understand how critical it is to work in an ... such as software development, engineering, IT, and a wide variety of ... enhancements of existing value chains/streams..
Job Information Humana Data Manager / ETL Developer - Primary Care Organization in Glen Allen Virginia Description The Data Manager 2 supports all aspects of configuration control, data management, and deficiency ..
