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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 Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
... skills, the nursing process, individualized healthcare plans (IHPs), and established school ... between school personnel, the family, healthcare professionals, and the community. 3. ... 4. Develop and implement individualized..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
... Permanent PositionnLicensure: Board Certifiednn nMPLT Healthcare is looking for physicians who ... benefits and CMEnnAbout MPLT HealthcarenMPLT Healthcare specializes in placing well-qualified physicians ... placing well-qualified physicians and advanced..
Job ID 21000LVFAvailable Openings 1 PURPOSE AND SCOPE: Manages the provision of quality patient care in an independent home therapy program while maintaining cost-effective clinical operations in accordance with all legal, ..
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 Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
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 ..
RN—ClinicalAbout this role: As a Dialysis Clinic Registered Nurse (RN) with Fresenius Medical Care, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing ..
... San Antonio Texas Description The Healthcare Quality Reporting & Improvement (HQRI) ... clinical industry representative. As a leader, this role leads HQRI's Provider ... guidance to ensure physician and..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description The Director, Physician Leadership relies on medical background and reviews health claims. The Director, Physician Leadership requires an in-depth understanding of how organization capabilities interrelate across the function or segment. ..
... Senior nurse Clinical Strategy and Practice role in site selection of ... markets through the analysis of healthcare data, identification of target patient ... markets. The Clinical Strategy and..
... San Antonio Texas Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..
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 ..
... Humana Lead Product Manager - Healthcare API in San Antonio Texas ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..