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Description The Manager, Vendor Management works as liaison ... between vendors and organization. The Manager, Vendor Management works within specific ... schedules and goals. Responsibilities The Manager, Vendor Management reviews..
... (ACD) defined in the TRICARE Operations Manual Chapter 18, section 4. ... section 4. Responsibilities The UM Manager will lead a team of ... guiding clinical decisions. The UM..
... 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, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... schedules and goals. Responsibilities The Manager, Care Management oversees..
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 ..
... 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..
... overseeing the vendor's claims processing operations and systems. The Director, Claims ... comprised of four units: claims operations, claims systems change management, claims ... Medical Management, Customer Service, Network..
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 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 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 Manager, Behavioral Provider Contracting - Remote ... San Antonio Texas Description The Manager, of Behavioral Health Provider Contracting ... to resources, approach, and tactical operations for projects..
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 ..
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 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 Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management 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..
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 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..
... as defined by the TRICARE Operations Manual (TOM), Chapter 18 Section ... relate to resources, approach, tactical operations and initiatives involving own departmental ... Qualifications 3 plus years of..
Job Information Humana Medicaid Associate Director, Compliance Nursing in San Antonio Texas Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
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 Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
