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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 ..
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Description The Field Care Manager NP assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
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 ..
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..
... Clinical Analytics and Trend Program Manager in Charlotte North Carolina Description ... Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... progress and performance against the..
... quality collaboration between Business and IT, guiding test strategies and tools ... with leaders across Business and IT -Being a positive change agent ... date, and dependencies, to the..
Description As the Associate Director, IT Project Management, you will use your ... appropriate to meet program and project needs, mitigating overall delivery risk, ... and reporting on program and..
... acumen to solve for the healthcare challenges of today. The Clinical ... anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... progress and performance against the..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare ... Carolina Description The Lead Product Manager Conceives of, develops, delivers, and ... customer use. The Lead Product..
... KEY ACCOUNTABILITIES Process Improvement and Project Management Contributes to the identification ... projects, key insights, and ensure project milestones and deliverables are implemented ... manner Develops and manages detailed..
Job Information Humana Healthcare Lead Product Manager: Hispanic Segment Medicare Advantage in ... Carolina Description The Lead Product Manager Conceives of, develops, delivers, and ... customer use. The Lead Product..
Job Information Humana Manager, Behavioral Provider Contracting - Remote in Charlotte North Carolina Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers ..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
