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Description The Director, Process Improvement analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Director, Process Improvement requires an in-depth understanding ..
Job Information Humana Manager, Behavioral Provider Contracting - Remote ... Portsmouth New Hampshire Description The Manager, of Behavioral Health Provider Contracting ... to resources, approach, and tactical operations for projects..
... 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..
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 21000EIKAvailable Openings 1 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 ..
Job ID 21000GDAAvailable Openings 1 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of ..
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 ..
Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... schedules and goals. Responsibilities The Manager, Utilization Management Nursing..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Government. Responsibilities The Telephonic Care Manager will..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Portsmouth New Hampshire Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
... 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 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 ..
Description The Care Coach 1 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 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 ..
Description The Senior Product Manager - Fully Insured supports strategy ... business. Responsibilities The Senior Product Manager supports all phases of the ... desired outcomes. The Senior Product Manager will..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary. The PDC Care..
Description The Lead Product Manager for Specialty products leads all ... Position Overview The Lead Product Manager Leads all phases of the ... Key Responsibilities The Lead Product Manager works..
Description The Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
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 ..