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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 ..
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Description The Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... you succeed, we succeed! The Manager, Care Management oversees..
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 ..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
Description The Provider Contracting Professional 2 initiates, negotiates, ... initiates, negotiates, and executes dental provider contracts and agreements for an ... that provides health insurance. The Provider Contracting Professional 2..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary...
... (CCM) organization is seeking a Manager, Fraud & Waste to join ... & Waste to join the Provider Payment Integrity-Clinical Audit team working ... As the Fraud & Waste..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... a personalized, seamless and easy..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Government. Responsibilities The Telephonic..
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 ..
