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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 ..
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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
Description The Behavioral Health Clinical Advisor (Care Manager, Telephonic Behavior Health 2) will audit CPT (Current Procedural Terminology) codes to ensure correct billing under TOM (TRICARE Operations Manual) policies in accordance ..
Description The Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
... within a context of regulatory compliance, and work is assisted by ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
Description The Senior Product Manager - Fully Insured supports strategy ... business. Responsibilities The Senior Product Manager supports all phases of the ... desired outcomes. The Senior Product Manager will..
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 Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..
Description Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical best ..
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 Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... you succeed, we succeed! The Manager, Care Management oversees..
Description The Lead Product Manager for Specialty products leads all ... Position Overview The Lead Product Manager Leads all phases of the ... Key Responsibilities The Lead Product Manager works..
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 ..
... Information Humana Medicaid Associate Director, Compliance Nursing in Colorado Springs Colorado ... Colorado Description The Associate Director, Compliance Nursing reviews utilization management activities ... and abuse. The Associate Director,..
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 ..
Description The Care Manager, Telephonic Behavioral Health 2, in ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... Humana is seeking a Care Manager, Telephonic Behavioral..
