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Physician Advisor, Utilization Management','Full-time','Hospitalist','Days','Days','80','80','Occasional','Occasional','COLORADO-ENGLEWOOD-DENVER INVERNESS','','!*!Job Summary: As the Utilization Management physician advisor, the Physician Advisor (PA) conducts clinical case reviews referred by case management staff and/or other health care professionals to ..
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... and providing input to medical planning that support the safe and ... Experts to provide input into planning, matrix initiatives, and requests for ... two-way engagement with customers. Medical..
Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments ..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
Description The Lead Product Manager for Specialty products leads all phases of the product life cycle for Dental, Vision and Life products, from inception to introduction into the marketplace. Responsibilities Position ..
Description The Senior Clinical Pharmacy Advisor - Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high performing team that helps ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
... Responsibilities Accountable for strategic product planning and establishing a shared vision ... 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 Actuary, Analytics/Forecasting will be the actuarial leader within Care Delivery finance. They will be the national subject matter expert (SME) for financial claims analytics and work in conjunction with ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
... Provides business intelligence and strategic planning support for business segments or ... (ECM) team needs your business, healthcare and research acumen to solve ... acumen to solve for the..
Description Come join the Digital Health & Analytics (DH&A) team within Humana to build a world class Data Science and Insights enterprise capability leveraging digital-first platforms, analytics, and agile development methodologies. ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
Job Information Humana Senior Product Management Professional / Release Train Engineer in Colorado Springs Colorado Description The Senior Product Management Professional / Release Train Engineer must be able to lead, plan ..
Description The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high ..
Description The Pharmaceutical Manufacturer Relations Executive ensures the Pharmacy trade strategy aligns with formularies and the desired health outcomes of patients. The Pharmaceutical Manufacturer Relations Executive works on problems of diverse ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Job ID 21000H1IAvailable 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 ..