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Description The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments ..
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Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
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 ..
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 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 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 Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
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 ..
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 ..
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 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 ..
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 ..
... 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 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 ..
... 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 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 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 ..
Job Information Humana Senior Product Management Professional / Release Train Engineer in Torrance California Description The Senior Product Management Professional / Release Train Engineer must be able to lead, plan and ..
Description The Senior Clinical Business Professional manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Senior Clinical Business Professional ..
