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Description The Problem, Incident and Event Management Engineer 2 monitors trends in incidents and system issues and helps drive technical support teams to recover services during periods of service disruption or ..
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Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills ... determinations. The Associate Director, Utilization Management Nursing requires a solid understanding ... process. The Associate Director, Utilization Management..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills ... administration determinations. The Manager, Utilization Management Nursing works within specific guidelines ... goals. Responsibilities The Manager, Utilization Management Nursing..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
... Director, Problem, Incident and Event Management drives technical support teams to ... Director, Problem, Incident and Event Management requires a solid understanding of ... Director, Problem, Incident and Event..
... purpose is to provide care management program support resources to physicians, ... physicians, physician groups, and integrated healthcare delivery systems throughout the country. Healthcare isn't just about health anymore...
... look for a Senior Business Systems Analyst to join working remote ... the US! The Senior Business Systems Analyst performs analysis of business, ... requirement specifications. The Senior Business..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
... Care Managers, because our case management services are centered on the ... by ability to navigate multiple systems, utilizing dual computer monitors. Provide ... for optimal performance from Humana..
Description The Senior Product Manager conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of ..
Description The Care Management Support Assistant 3 contributes to ... contributes to administration of care management. Provides non-clinical support to the ... wellbeing of members. The Care Management Support Assistant..
... accuracy of formularies and utilization management (UM) criteria in the Formulary ... Collaborates with other pharmacists and healthcare professionals in a team environment ... an expert in Humana's formulary..
... accounts and/or provider relations Associate management oversight of 3-5 direct reports ... 3-4 years of progressive network management experience including hospital contracting and ... and network administration in a..
Description Humana is looking for an experienced Counselor that truly enjoys helping those in need within a call center environment. Our Counselor's provide ongoing and crisis intervention counseling focused on the ..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
... and possible participation in care management. The clinical scenarios predominantly arise ... health, or disease or care management. Medical Directors support Humana values, ... whether services provided by other..
... the Associate Director, IT Project Management, you will use your background ... background and experience in program management to lead and manage a ... The Associate Director, IT Project..
Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
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 UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
... care facility The Supervisor, Care Management Support will lead a team ... contributes to administration of care management. Provides non-clinical support to the ... of members. The Supervisor, Care..
