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16

Healthcare Improvement Specialist Jobs

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Company
**********
Location
Jersey City, NJ
Posted Date
Jun 26, 2023
Info Source
Employer  - Full-Time  90  

Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Sep 14, 2021
Info Source
Employer  - Full-Time  90  

Job Information Humana Actuary, Risk and Compliance in Jersey City New Jersey Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Sep 24, 2021
Info Source
Employer  - Full-Time  90  

... We are the future of healthcare and our mission is to ... will help members through their healthcare journey, ensuring they get the ... are: Passionate about transforming our..

 
Company
**********
Location
Jersey City, NJ
Posted Date
May 04, 2023
Info Source
Employer  - Full-Time  90  

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Apr 06, 2022
Info Source
Employer  - Full-Time  90  

Job Information Humana FP&A Lead, Medicaid Market in Jersey City New Jersey Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Oct 17, 2021
Info Source
Employer  - Full-Time  90  

Description The RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Apr 20, 2023
Info Source
Employer  - Full-Time  90  

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 ..

 
Company
**********
Location
Jersey Shore, PA
Posted Date
Feb 25, 2022
Info Source
Employer  - Full-Time  90  

Posted: 23-Feb-22 Location: Jersey Shore, Pennsylvania Type: Part Time Salary: Open Categories: General Nursing Internal Number: R-23128 Job Summary Phlebotomist II is responsible and accountable for performing a wide range of ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Sep 23, 2022
Info Source
Employer  - Full-Time  90  

Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
May 13, 2022
Info Source
Employer  - Full-Time  90  

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Oct 05, 2022
Info Source
Employer  - Full-Time  90  

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..

 
Company
Humana Inc.
Location
Jersey City, NJ
Posted Date
Apr 22, 2023
Info Source
Employer  - Full-Time  90  

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Apr 20, 2023
Info Source
Employer  - Full-Time  90  

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Dec 16, 2021
Info Source
Employer  - Full-Time  90  

Description The Staff Clinical Pharmacist is an integral part of the Clinical Drug Policy Management team which ensures synchronization of formulary utilization management policies across multiple systems. Humana is seeking a ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Apr 06, 2022
Info Source
Employer  - Full-Time  90  

Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..

 
Company
**********
Location
Jersey City, NJ
Posted Date
Mar 21, 2022
Info Source
Employer  - Full-Time  90  

Job Information Humana Medicare Appeals and Grievance Medical Director in Jersey City New Jersey Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for ..

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