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... overseeing the vendor's claims processing operations and systems. The Director, Claims Oversight plays a vital ... comprised of four units: claims operations, claims systems change management, claims ... Medical..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... a personalized, seamless and easy..
Description The Director, Process Improvement analyzes, and measures ... quantifiable business process improvements. The Director, Process Improvement requires an in-depth ... function or segment. Responsibilities The Director, Process Improvement researches..
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 Autism ..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
Description Responsibilities The Associate Director for ACD Audit , at ... ACD Audit , at the director of the Director of Payment Integrity, will create ... optimizing operational processes. The..
Description The Director of Product Management for Clinical ... business acumen. Responsibilities As the Director of Product Management for Clinical ... and services. Partners closely with operations, vendors, customer success..
Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
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 Humana ..
Description The Medical Director actively uses their medical background, ... work. Responsibilities Title: Commercial Medical Director Location: Work At Home - ... weeks. Job Summary The Medical Director's work includes..
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 Management ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Green Bay ... Bay Wisconsin Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
Description The Lead Product Manager for Specialty products leads all phases of the product life cycle for Dental, Vision and Life products, from inception to introduction into the marketplace. Responsibilities Position ..
Description The Director, Provider Reimbursement is responsible for ... the organization to include Network Operations, Provider Administration, Claims, and IT. ... team of associates. Responsibilities The Director, Provider Reimbursement develops..
Description The Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... grow, the National Medicaid Clinical Operations team is..
... closely with the market QI director on a frequent basis. Support ... expertise within the realm of Healthcare Quality operations and improvement methodology, HEDIS/CAHPS and ... a subject matter..
