Healthcare Operations Jobs

The healthcare consultant will perform the following responsibilities: Conduct analysis of health plan and provider functional areas to identify impacts, opportunities and risks related to the implementation of ICD-10, create high ..

:text,ActualValueFromSolar:null},{QuestionName:Auto req ID,AnswerValue:13497BR,VerityZone:autoreq,QuestionType:text,ActualValueFromSolar:null},{QuestionName:Job Description,AnswerValue:u003ctable border= cellpadding= cellspacing= dir=ltr style=border-collapse:collapse;\u003eu003ctbodyu003eu003ctru003eu003ctd style=width:679px;border:none;border-top:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;vertical-align:top;\u003eu003cdiv style=text-align: center;\u003eu003cfont style=font-size:14px;\u003eu003cstrongu003eu003cfont style=color:undefined;font-family:arial,sans-serif;size:undefined;\u003eGIANT FOOD PHARMACY IS NOW HIRING Au003cbru003eSTAFF PHARMACISTu003cbru003eTO WORK IN OUR STORES IN ..

Job Information Humana Manager, Behavioral Provider Contracting in Washington District Of Columbia Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and ..

Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..

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. ..

Job ID 21000IA7Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

Job Information Humana Senior Fraud & Waste Investigator - Remote in Washington District Of Columbia Description Are you looking to be a part of a Fortune 100 company with competitive salary, ..

Job ID 21000GS7Available Openings 2PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

... 60 market leader in integrated healthcare with a clearly defined purpose ... us redefine the future of healthcare. With a history of transformation ... about solving big problems in..

Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..

... deep understanding of: The current healthcare business landscape Humana's vision for ... for its new role in healthcare Population Health Management Healthcare operations and strategy Significant exposure to .....

... and services. Partners closely with operations, vendors, customer success teams and/or ... insights Bachelor's degree in Business, Healthcare Administration or other related fields ... 50 market leader in integrated..

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 ..

Job ID 21000G9EAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

Job Information Humana Manager, Behavioral Provider Contracting - Remote in Washington District Of Columbia Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to ..

Job Information Humana Senior Product Management Professional / Release Train Engineer in Washington District Of Columbia Description The Senior Product Management Professional / Release Train Engineer must be able to lead, ..

Job ID 210008YLAvailable Openings 1Position Specific Information This position is offering a $2,000 sign-on bonus for the right person!! PURPOSE AND SCOPE:Organizes the care and follow up for late stage CKD ..

Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..

Description The Mail Operations Pharmacy Technician 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The associate assists the ADS Implementation & ..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Washington District Of Columbia Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, ..

Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..

Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..

... Services for National Medicaid Clinical Operations utilizes clinical skills to support ... grow, the National Medicaid Clinical Operations team is expanding our shared ... Services for National Medicaid Clinical..