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Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization..
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Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for..
Job Information Humana Senior Accreditation Professional in Portsmouth New Hampshire Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates,..
Description The Clinical Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice..
Job Information Humana Actuary, Risk and Compliance in Portland Maine Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare..
$150 Bonus within 90 days! Extended Family is looking for a LIVE-IN Home Health Aide who truly loves what they do. Food and living expenses are included. The right Aide..
Job Information Humana Senior Accreditation Professional in Portland Maine Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance..
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Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The..
Job Information Humana Actuary, Risk and Compliance in Portsmouth New Hampshire Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special..
