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Description The Medical Coding Coordinator 3 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 ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation, and billing for services rendered, is complete, compliant and accurate to support optimal reimbursement. The Nurse ..
Description The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
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 Care Coach 1 - Pinellas County, FL in Largo Florida Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Job Information Humana Care Coach 1 - Pinellas County, FL in Saint Petersburg Florida Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal ..
Job Information Humana Care Coach 1 - Pinellas County, FL in Clearwater Florida Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness ..
Job Information Humana Clinical Provider Quality Improvement Field RN - Orange, Osceola, Polk County, FL in Tampa Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and ..
Job Information Humana Care Coach 1 - Bilingual (English/Spanish) - Tampa, FL in Tampa Florida Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain ..
Description The Senior Wellness Program Professional responsible for educating and motivating clients/employers to participate in the wellness program. The Senior Wellness Program Professional work assignments involve moderately complex to complex issues ..
Job Information Humana Field Care Manager Nurse 2 - Escambia County, FL in Tampa Florida Description The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve ..
Description The Consumer Engagement Professional 2 oversees the enrollment, education, engagement, and activation duties for client groups regardless of segment, and for product where warranted. The Consumer Engagement Professional 2 work ..
Description Humana is looking for an experienced Counselor that truly enjoys helping those in need within a call center environment. Our Counselor's provide ongoing and crisis intervention counseling focused on the ..
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 Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Associate VP of Payment Innovation supports the creation of new value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Associate VP of ..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
