Healthcare Improvement Specialist Jobs in Puerto Rico

... 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..

... of Health and Wellness quality improvement projects; analyzing and summarizing quality ... and services; and leading quality improvement projects for Kroger Health with ... assurance expert in process change/performance..

... a member of the interdisciplinary healthcare team, supporting the FMCNA commitment ... and Quality Assessment and Performance Improvement (QAI) activities. Actively participates in ... activities. Actively participates in process..

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 ..

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 ..

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 ..

PURPOSE AND SCOPE: Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the USV/FMCNA Compliance Program, including following all regulatory and USV/FMS policy requirements.Under the direct supervision of ..

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 ..

Job Information Humana Medicare Appeals and Grievance Medical Director in San Juan Puerto Rico Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for ..

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

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 ..

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 ..