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Description Responsibilities The Senior Market/Industry Insights Professional delivers clinical/medical policy insight and information to both internal and external customers for Humana Government Business (HGB). The Senior Market/Industry Insights Professional will draft ..
Description Responsibilities The Senior Clinical Insights Professional delivers clinical policy insight and information to both internal and external customers for Humana Government Business (HGB). The Senior Clinical Insights Professional will draft ..
Description The Provider Relations Executive is responsible for network provider training, education, and provider relations including the creation and management of provider and staff training curriculum and content, scheduling external training ..
... 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..
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 ..
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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 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..
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 ..
... 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 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 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..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Lancaster South ... South Carolina Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
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 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..
... health. Dedicated to simplifying the healthcare experience and helping people navigate ... and helping people navigate their healthcare journey, Author is leveraging digital ... a new path for the..
Description The Director, Health Services utilizes clinical nursing ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... segment. Responsibilities The SC Medicaid Director, uses clinical knowledge,..
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 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 Responsibilities The Quality Improvement Lead provides strategic leadership for Humana's South Carolina Medicaid Quality Program, in alignment with organizational quality and population health goals and ensuring compliance with all contract, ..
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 ..
