Healthcare Performance Improvement Jobs

Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..

Job Information Bristol Myers Squibb Senior Global Feasibility Lead in Jersey City New Jersey Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver ..

... updates of in-line product business performance. Monitor launch product performance and signal risks to leadership ... , comprehensive view of business performance assessment Develop relevant performance KPIs, leading indicators,..

Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..

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

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 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 ..

Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..

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 ..

... 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..

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 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 ..

... 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..

Job Information Humana Actuary, Risk and Compliance in Jersey City New Jersey Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special ..

... bring? The US Hematology Commercial Performance member will provide strategic Insights, ... will provide strategic Insights, overall performance diagnostics and guidance to key ... business leaders to maximize financial..

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 ..

... 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..

... 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..

Description Responsibilities This position will maintain the Humana Military ACD website Autism Center of Excellence (CoE); ensuring educational information is current and relevant to training needs in addition to analyzing and ..

... Director for US Hematology Commercial Performance will provide strategic Insights, overall ... will provide strategic Insights, overall performance diagnostics and guidance to key ... business leaders to maximize financial..

... 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..

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..

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 ..