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Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Supervisor, Grievances & Appeals ..
Description The Subrogation Professional 2 iIdentifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health ..
Description The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral ..
Description The Subrogation Professional II identifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health ..
Description The Bilingual Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further ..
Job Information Humana Care Manager, Telephonic Nurse 2-Remote (Eastern Standard Time) in Charleston West Virginia Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs ..
Job Information Humana Administrative Sales Support/Event Coordinator Representative - Charleston, WV in Charleston West Virginia Description The Administrative Sales Support/Event Coordinator Representative - Charleston, WV provides timely and effective administrative support ..
... coordination, documentation and communication of medical services and/or benefit administration determinations. ... in reviewing actual and proposed medical care and services against established ... against established CMS and Humana..
Job Information Humana Manager, Utilization Management RN - Remote in Charleston West Virginia Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..
Job Information Humana Manager, Specialty Pharmacy Sales in Charleston West Virginia Description The Manager, Pharmacy Sales - Specialty leverages targeted geographic analysis, engages with Physician offices to influence physicians to route ..
Professional, Web Content & French CA Translations (Remote) Date: May 31, 2022 Location: Remote, US Company: Under Armour Under Armour has one mission: to make you better. We have a commitment ..
Description The Senior Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Senior Utilization ..
Job Information Humana Consumer Engagement Professional in Charleston West Virginia Description The Consumer Engagement Professional 2 oversees the enrollment, education, engagement, and activation duties for client groups regardless of segment, and ..
Description . Responsibilities The Process Improvement Lead researches best business practices within and outside the organization to establish benchmark data. This individual collects and analyzes process data to initiate, develop and ..
Description The Supervisor, Grievances & Appeals manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if a grievance, appeal, or further request is warranted ..
Job Information Humana Care Manager, Telephonic Nurse 2 Certified Diabetes Care and Education Specialist-Remote-US in Charleston West Virginia Description The Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ..
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 ..
