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... section 4. Responsibilities The UM Manager will lead a team of ... and every six-month reauthorizations thereafter. Associate will utilize specified UM tools ... guiding clinical decisions. The UM..
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Job Information Humana Manager, Behavioral Provider Contracting - Remote in San Antonio Texas Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers ..
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 ..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
Description As the Associate Director, IT Project Management, you will use your ... for our Medicare segment. The Associate Director is responsible for setting ... appropriate to meet program and..
... 41) market leader in integrated healthcare with a clearly defined purpose ... experience and vitality of the associate community. Through offerings anchored in ... we are seeking an experienced..
Job Information Humana RN Case Manager / Care Coach - San Antonio, TX in San Antonio Texas Description At Conviva Care Solutions, we want to inspire people to live life their ..
... and experiences (beneficiary, provider and associate). The Lead defines improvement projects ... KEY ACCOUNTABILITIES Process Improvement and Project Management Contributes to the identification ... projects, key insights, and ensure..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
... acumen to solve for the healthcare challenges of today. The Clinical ... anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... progress and performance against the..
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 ..
... facing partnerships to engage Humana Associate population Identifying opportunities for ongoing ... outreach, status/progress to include: Consumer, Associate, Neighborhood groups, Nonprofit community agencies, ... Leadership of employee Training and..
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 Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... schedules and goals. Responsibilities The Manager, Care Management oversees..
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..
... Clinical Analytics and Trend Program Manager in San Antonio Texas Description ... Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... progress and performance against the..
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 ..
