- Humana (Madison, WI)
- …community and help us put health first** The Associate Actuary, Risk and Compliance is responsible for the overall management and oversight of activities concerned ... and cost-effective approaches to minimize risks. The Associate Actuary, Risk and Compliance work assignments involve moderately complex to complex issues where the… more
- Humana (Madison, WI)
- …clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed ... **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The … more
- Evolent (Madison, WI)
- …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Evolent (Madison, WI)
- …is preferred + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology… more
- Evolent (Madison, WI)
- …Computer Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... Doing: + Serve as the Physician match reviewer in Medical Oncology and imaging cases, that do not initially...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Evolent (Madison, WI)
- …Computer Proficiency . Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review… more
- Humana (Madison, WI)
- …(DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services' Medicare Shared Savings Program (MSSP), plus ... other commercial and Medicare Advantage value based programs. DVACO is a joint...starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits +… more
- Humana (Madison, WI)
- …submissions to Medicaid/ Medicare . Ensures encounter submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the ... encounter acceptance rate by Medicaid/ Medicare . Looking for long-term improvements of encounter submission processes. Begins to influence department's strategy. Make… more
- Banner Health (WI)
- …to our award-winning patient care. POSITION SUMMARY This position evaluates medical records, provides clinical and surgical abstraction for full range of ... department projects, validation edits and/or revisions. CORE FUNCTIONS 1. Analyzes medical information from medical records. Accurately codes diagnostic and… more
- Humana (Madison, WI)
- …of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical ... in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related group (DRG)… more