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... 1 year of experience in healthcare, medical, or insurance related industriesuf0b7 ... or insurance related industriesuf0b7 Direct healthcare experience in medical case management or quality assurance to include .....
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... Grief counseling, workplace problems, and management consultation. Understands department, segment, and ... documentation and multi-tasking Experience providing management consultation Experience developing and delivering ... by delivering personalized, simplified, whole-person..
... the GEHC Quality Manual, Quality Management System, Quality Management Policy, Quality Goals, and applicable ... but not limited to GE Healthcare HIPAA Guidelines, NEMA Regulations, etc.) ... but not..
... purpose is to provide care management program support resources to physicians, ... physicians, physician groups, and integrated healthcare delivery systems throughout the country. ... delivery systems throughout the country...
Description The Utilization Management Nurse utilizes clinical nursing skills ... benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... by delivering personalized, simplified, whole-person healthcare experiences. Recognizing..
... and supports data-driven transformation of healthcare by enabling healthcare and life sciences organizations to ... supporting key patient services and healthcare use cases including defining personas, ... top institution..
Description Humana's Enterprise Clinical Management team needs your clinical, business ... acumen to solve for the healthcare challenges of today. The Clinical ... Care initiative program and process management Manages,..
Description Job Summary The Utilization Management Behavioral Health Professional 2 utilizes ... benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... of action. Responsibilities The Utilization Management..
... in both the treatment and management of most chronic and acute-care ... contributes to administration of care management. This role is a key ... Care team resources and care..
Description The Actuary, Analytics/Forecasting will develop the financial forecast for the dental and vision benefits included within Humana's growing Medicare Advantage business, as well as pricing and oversight of other stand ..
Description The Manager, Care Management leads teams of nurses and ... health professionals responsible for care management. The Manager, Care Management works within specific guidelines and ... goals. Responsibilities The..
Description The Utilization Management Behavioral Health Professional 2 utilizes ... benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... of action. Responsibilities The Utilization Management Behavioral Health..
Description The Utilization Management Nurse 2 utilizes clinical nursing ... benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... of action. Responsibilities The Utilization Management Nurse 2..
... relationships with physicians, providers and healthcare systems in order to support ... incentive programs, quality and clinical management, population health, data sharing, connectivity, ... care with Provider Contracting, Network..
... the day-to-day selling and/or account management for commercial specialty sales. Accountable ... equivalent professional experience Strong relationship management and customer service skills required ... telesales business to business experience..
Description Be a part of the eBusiness team, drivers of provider self-service adoption through education and promotion of electronic transactions the Availity secure provider portal, Watson Voice, EDI, etc. As a ..
... ECOM leadership team with Program management & Pipeline trend management efforts Work with various Humana ... Minimum 2 years working in healthcare or a related industry 3 ... and..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
Description The Utilization Management Nurse 2 utilizes clinical nursing ... benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... technology allows Responsibilities The Utilization Management Nurse 2..
... and supports data-driven transformation of healthcare by enabling healthcare and life sciences organizations to ... of key patient services and healthcare use cases including defining personas, ... external stakeholders..
... Care Managers, because our case management services are centered on the ... Previous adult chronic conditions care management. Previous experience in care management. Knowledge of complex care management and..
