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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 Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs..
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..
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..
Description The Senior Product Manager conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis..
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..
Immediate openings for full-time and part-time Resident Aides and CNAs at Brookdale Rio Rancho Assisted Living. We're pleased to rank as a top place to work, offering our care team..
Job Information Humana Senior Accreditation Professional in Albuquerque New Mexico 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 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..
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,..
Job Information Humana Actuary, Risk and Compliance in Albuquerque New Mexico Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special..
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..
Job ID 21000FKWAvailable Openings 1 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision..
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..
