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Description The Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Associate Director, Care Management requires a solid understanding of how organization capabilities ..
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Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a few powerful teams dedicated to reducing waste and abuse in the health care industry and its impacts on Humana. These teams ..
Description The Genetic Counselor 2 responsible for evaluating and understanding member's risk of inherited medical condition. The Genetic Counselor 2 work assignments are varied and frequently require interpretation and independent determination ..
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 SeniorBridge/Humana is seeking a Care Management Support Assistant. This professional contributes to the successful administration of home care by providing administrative support in new and existing Home Care markets. This ..
... roadmaps. Working closely with the Associate Vice President of Pharmacy Product ... insights Bachelor's degree in Business, Healthcare Administration or other related fields ... 50 market leader in integrated..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Dover ... in Dover Delaware Description The Associate Director, Compliance Nursing reviews utilization ... fraud, waste, and abuse. The Associate Director,..
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 requires ..
Full-time position helping survivors of domestic violence to obtain housing and/or employment. This position requires safety-planning, community advocacy, and accompanying survivors to look at housing prospects. Experience in the field of ..
Part-time position working in Georgetown, Milford and Dover, working weekends. Responsibilities include assisting with the day-to-day operations of the Family Visitation Center by ensuring a safe, healthy environment for supervised visits ..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
Job ID 21000AEOAvailable Openings 1 PURPOSE AND SCOPE: Supports FMCNA’s mission,vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including followingall regulatory and FMS policy requirements. Functions ..
Description The Associate Actuary, SPA RX will be mainly responsible for supporting the pricing work related to our standalone Prescription Drug Plans (PDPs). This includes both bid development and reforecasts throughout ..
... that our members receive quality healthcare at an affordable price. You ... (RN) license 3 years of healthcare experience within a fraud investigations ... well as solid knowledge of..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural Healthcare Distinction, and/or LTSS Distinction Auditing ... job as we are a..
Description The Mail Operations Pharmacy Technician 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The associate assists the ADS Implementation & ..
Description As the Associate Director, IT Project Management, you will use your background and experience in program management to lead and manage a team of PMO professionals that support the delivery ..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..
Description Responsibilities The Associate Director for ACD Audit , ... as optimizing operational processes. The Associate Director will lead design and ... to the ACD leaders. The Associate Director will..
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 varied ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for claims reserve valuation, financial forecasting, and strategic and operational decisions within ..