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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Job Locations: US-Virtual/Remote Category: Medical Coding Are you interested in joining one of the nation’s leading providers of medical coding services that is experiencing impressive year-over-year growth? Mommy Jobs Online is ..
We have exciting employment opportunities for remote HIM Coding Specialists on our Outsource Coding Team. Position Summary The HIM Coding Specialist will handle medical coding and data entry / abstraction for ..
Job Location Merrimack, NH - 3603 - Merrimack, NH Position Type Full Time Salary Range $37,000.00 - $38,000.00 Salary/year There's a spot on our team waiting for you! Become a Team ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
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 ..
Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..
Description Job Description Summary 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 ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Portsmouth New Hampshire Description Humana is looking for an experienced Healthcare Investigator to join its ..
The City of Dover Fire & Rescue is accepting applications for the positions of fulltime Firefighter/EMT, as well as to produce an eligibility list for anticipated vacancies. Salary Range: $23.48 to ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
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 ..
