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Description The Senior Clinical Business Professional manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Senior Clinical Business Professional ..
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... portfolio team to align the IT portfolio and demand. The Senior ... projects and programs based on IT Strategy, strategic roadmap, available and ... with and delivers on our..
... resolution. Discuss identified trends with leaders to investigate solutions to improve ... when necessary; discuss trends with leaders for collaboration with network & ... of excellence by adhering to..
Description Your Home Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving clinical and quality outcomes by bridging the gap between the physician's office and the member's home. YHA ..
Description The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for claims reserve valuation, financial forecasting, and strategic and operational decisions within ..
Description The Senior Compliance Professional will help to reach compliance program objectives by ensuring compliance with governmental regulations and laws, assessing risks and providing guidance to business areas. Responsibilities The Senior ..
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 Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Experience Strategy & Transformation Lead enhances the consumer experience by architecting experiences and building capabilities that will positively impact our customers. The Experience Strategy & Transformation Lead works on ..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..
Description The Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization Behavioral ..
... Takes complex data and makes it understandable and usable for stakeholders ... and usable for stakeholders and leaders, so that they can derive ... at least 3 years of..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Charleston West Virginia Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
Job ID 21000FMNAvailable Openings 2 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
... presentation to NCQA Advises operational leaders and frontline associates in developing ... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural..
Description The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..
Description The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
... machine learning and to see it become very real in a ... and external machine learning and IT partners have the guidance and ... at least 1 year of..
