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Description The Senior Stars Improvement, Clinical Professional is responsible for the development, implementation and management oversight of the company's Medicare/Medicaid Stars program. The Senior Stars Improvement, Clinical Professional work assignments involve ..
Description The Quality Assurance, Clinical Professional 2 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 2 work assignments are varied and ..
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Description The Senior Medical/Financial Risk Evaluation Professional is responsible ... development, implementation and monitoring of medical/financial risk. The Senior Medical/Financial Risk Evaluation Professional work assignments ... their financial, social, emotional..
Description The Senior Quality Assurance, Clinical Professional requires being both a nurse/RN and a certified Coder nurse as this position will be cross trained to review DRG (Diagnosis Related Group) audits ..
Description The Care Management Support Assistant 3 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
... the team with a Senior Medical Coding Auditor roles! This is ... have a solid background in medical auditing, coding and medical record review? Well, if you ... should..
... team with an Inpatient Senior Medical Coding Auditor roles! This is ... have a solid background in medical auditing, coding and medical record review? Well, if you ... should..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
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 Be a part of the CenterWell leadership team, a subsidiary whose purpose is to provide care management program support resources to physicians, physician groups, and integrated healthcare delivery systems throughout ..
... review team is seeking a Medical Coding Auditor with a special ... review information provided in the medical records they must understand what ... this information confidently to other..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description The Care Management Support Assistant 2 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Description The Care Management Support Assistant 2 (CMSA2) contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
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 Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Green Bay Wisconsin Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
Description Humana is a $77 billion (Fortune 41) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
