-
Humana
-
Jefferson City, Missouri
...
is seeking a Capture Lead, Clinical & Population Health Strategy, to lead initiatives developing and ... horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject
...
-
Humana
-
Jefferson City, Missouri
...
national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Medical Director's work includes computer based review of moderately complex to complex clinical scenarios
...
-
Humana
-
Jefferson City, Missouri
...
provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment ... providers to verify clinical information/discharge date and admission status
Document calls and attach
...
-
Humana
-
Jefferson City, Missouri
...
/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management ... regulatory compliance, and work is assisted by diverse resources, which may include national clinical
...
-
Humana
-
Jefferson City, Missouri
...
rates for provider contracts.
Works on various projects related to the analysis of claims, clinical and financial data, with a focus on improvement of financial and/or clinical outcomes.
Gathers
...
-
Humana
-
Jefferson City, Missouri
...
national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios
...
-
Humana
-
Jefferson City, Missouri
...
operations/management
4 or more years of experience with Vendor Management Systems, preferably SAP ... experience
Technical and Clinical Contingent Labor management experience
Excellent analytical
...
-
Humana
-
Jefferson City, Missouri
...
position with responsibility for utilization management and clinical decision-making as outlined in the ... associate will conduct clinical necessity reviews for requested ABA services when approving all treatment
...
-
Humana
-
Jefferson City, Missouri
...
organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical ... assisted by diverse resources which may include national clinical guidelines, CMS policies and
...
-
Humana
-
Jefferson City, Missouri
...
/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management ... regulatory compliance, and work is assisted by diverse resources, which may include national clinical
...
-
Humana
-
Jefferson City, Missouri
...
, Practice Transformation, Data Analytics, Post-Acute Care and Clinical Quality, and the opportunity to ... tailor their experience through various projects in quality oversight, data reporting, performance
...
-
Humana
-
Jefferson City, Missouri
...
provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT ... payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code
...
