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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 ..
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Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
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..
... acumen to solve for the healthcare challenges of today. The Clinical ... low value care and related healthcare resource waste, with a focus ... news and reports in the..
Description The Associate Director, Consumer Engagement oversees the enrollment, education, engagement, and activation duties for client groups regardless of segment, and for product where warranted. The Associate Director, Consumer Engagement requires ..
Description The Care Management Support Assistant 2 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... a personalized, seamless and easy..
... (CCM) organization is seeking a Manager, Fraud & Waste to join ... As the Fraud & Waste Manager at Humana, you will support ... so that our members receive..
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..
Description The Care Manager, Telephonic Behavioral Health 2, in ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... Humana is seeking a Care Manager, Telephonic Behavioral..
... Director, Compliance Nursing ensures mandatory reporting completed. Conducts and summarizes compliance ... Health Parity, Clinical compliance, and quality performance and staffing management. Detailed ... Audit team to assure high..
Description The Associate Director, Vendor Management works as liaison between vendors and organization. The Associate Director, Vendor Management requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities The ..
