- Humana (Frankfort, KY)
- …part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of medical ... requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related… more
- ChenMed (Louisville, KY)
- …1-2 days out of each week out of your home base market. The Senior Manager, Referrals is responsible for providing support to ChenMed, et. al regarding internal ... to guide the Chenmed company's on referral processes. The Senior Manager, Referrals is the subject matter expert in...decision based of the data + Experience working in Medicare managed care environment We're ChenMed and we're transforming… more
- Humana (Frankfort, KY)
- …Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement ... company's total revenue and earnings. Team members partner with senior leaders of the business unit, and more broadly...initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the… more
- Molina Healthcare (KY)
- …quality member intervention initiatives including all lines of business ( Medicare , Marketplace, Medicaid). Executes health plan's member and community quality ... excellent problem-solving skills. **PREFERRED QUALIFICATIONS:** + 1 year of experience in Medicare and in Medicaid managed care + Experience with data reporting,… more
- Datavant (Frankfort, KY)
- …work environment. + Keep up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide guidance and make strategic ... or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment, CDI, Medicaid, Commercial RA, and HEDIS experience. +… more
- Humana (Frankfort, KY)
- …of our caring community and help us put health first** We are seeking a Senior Accreditation Professional who will work in a team environment on Humana's health plan ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Molina Healthcare (KY)
- …+ Resolves complex provider issues that may cross departmental lines and involve Senior Leadership. + Serves as a subject matter expert for other departments. + ... various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for… more
- Humana (Frankfort, KY)
- …in both traditional machine learning and emerging generative AI technologies. As a Senior Engineer, you will play a key role in developing and deploying innovative ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Prime Therapeutics (Frankfort, KY)
- …decision we make. **Job Posting Title** Clinical Pharmacist (Algo), Professional- Senior - REMOTE **Job Description** Maintains the inventory of clinical algorithms. ... based upon relevant source data (eg clinical criteria, client criteria, Medicare LCD). Provides support for clinical client inquiries and internal partners.… more
- Humana (Frankfort, KY)
- …shaping the future of healthcare through AI excellence. We are seeking a Senior Data Scientist to develop reliable, interpretable, and steerable AI systems. Our goal ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more