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Description The UM Specialist contributes to administration of utilization ... of utilization management. The UM Specialist performs varied activities and moderately ... As a UM (Utilization Management) Specialist you will..
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 ..
Description The Medical Director actively uses their medical background, experience, and judgement to ... and other sources of expertise. Medical Directors will learn Medicare and ... in their daily work...
... for a ServiceNow PPM Technology Specialist to help drive and deliver ... Description The ServiceNow PPM Technology Specialist will work as part of ... application. The Senior Technology PPM..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Jersey City New Jersey Description Humana is looking for an experienced Healthcare Investigator to join ..
u003cpu003eu003cstrongu003eWho We Areu003c/strongu003eu003c/pu003enu003cpu003eu003ca href=u0022https://www.wpshealthsolutions.com/about/index.shtmlu0022 target=u0022_blanku0022 rel=u0022noopeneru0022u003eWPS Health Solutionsu003c/au003e is a leading not-for-profit health insurer in Wisconsin. Our services offer health insurance plans for individuals, families, seniors, and group plans for small ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Billings Montana Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
... team of 20-25 nurses and medical professionals that performs the following ... that performs the following functions: medical necessity/level of care reviews, provider ... education on the utilization and..
Job Information Humana Senior Professional, Sales and Marketing Support - Montana in Billings Montana Description Are you passionate about contributing to the well-being of the Medicare population? Are you looking for ..
u003cpu003eu003cstrongu003eRole Summaryu003c/strongu003eu003c/pu003enu003cpu003eAnswer inquiries from beneficiaries, providers, and other affiliated representatives or groups regarding TRICARE eligibility, benefit determinations, and claims adjudication questions or problems.u003c/pu003enu003cpu003eu003cstrongu003eIn this role you will:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eReceive telephone, written, fax, and ..
... SCOPE: The Revenue Cycle Training Specialist (trainer) will support process standardization ... or more focus areas (verifications, billing, collections, etc.) and will be ... EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity Fresenius..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Billings Montana Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special Investigations ..
Description The Medical Director relies on medical background and reviews health claims. ... and reviews health claims. The Medical Director work assignments involve moderately ... of variable factors. Responsibilities The..
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 ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Green Bay Wisconsin Description Humana is looking for an experienced Healthcare Investigator to join its ..
... Healthcare. Across our family of medical centers, we support each one ... contract negotiations. Collaborate with Payment Specialist team to determine accuracy of ... contracts to maintain the Hospital..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Honolulu Hawaii Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Atlanta Georgia Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Billings Montana Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing clinical ..