Healthcare Performance Improvement Jobs

INDIANAPOLIS AND SURROUNDING AREAS Join a leader in the home health care industry. Each independently owned BrightStar location makes more possible for the community and clients it serves. If providing compassionate, ..

Description The Director, Process Improvement analyzes, and measures the effectiveness ... process improvements. The Director, Process Improvement requires an in-depth understanding of ... segment. Responsibilities The Director, Process Improvement researches..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Indianapolis Indiana Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..

Description The Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization Behavioral ..

... that our members receive quality healthcare at an affordable price. You ... recommendations Identify and suggest process improvement opportunities Develop and monitor team ... and coaching, and conduct annual..

... Autism Care Demonstration (ACD) team performance to ensure compliance with contract ... by ACD associates to assure performance compliance. Advises leadership to develop ... KEY ACCOUNTABILITIES 30 % Ensures..

Description The Senior Quality Improvement Professional will focus organizational efforts ... Use Disorder (SUD) clinical quality performance measures to achieve optimal performance and quality for the Humana ... Director, Behavioral..

Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The Pharmacy ..

... and actively participates in process improvement activities that enhance the likelihood ... competency evaluations/audits to ensure ongoing performance of other PCT’s. Collaborates with ... the practice of Continuous Quality..

Job Information Humana Actuary, Risk and Compliance in Indianapolis Indiana Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..

Description As Lead Actuary of the Risk Predictive Models team, you have an opportunity to both learn more about predictive analytics and machine learning and to see it become very real ..

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 Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..

Description The Senior Quality Improvement Professional will focus organizational efforts ... improving Kentucky Medicaid clinical quality performance measures to achieve optimal performance and quality for the Humana ... Works closely..

... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Ensure adherence to policies and performance standards in accordance with the ... participate in Care Management quality..

Job Information Humana Compliance Lead - Illinois Medicaid in Indianapolis Indiana Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ..

Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..

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 ..

... relationships with physicians, providers and healthcare systems in order to support ... and improve financial and quality performance within the contracted working relationship ... across such areas as financial..

... 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..

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 ..

... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Ensure adherence to policies and performance standards in accordance with the ... participate in Care Management quality..