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Job Information Humana Medicaid Associate Director, Compliance Nursing in Montpelier Vermont ... Montpelier Vermont Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
... 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 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 ..
A. SCOPE OF WORK: The lead nurse will mentor and support school-based nurses and nurse substitutes in the coordination of school health services, which includes the coordination of the district’s medical ..
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 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 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 ..
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 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..
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 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 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 ..