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Description Market Development Advisor supports the Regional President, Humana Florida Medicaid, by leading strategic health plan initiatives in collaboration with senior health plan leaders and across the enterprise. This role partners ..
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 Clinical Provider Quality Improvement Field RN - Orange, Osceola, Polk County, FL in Tampa Florida Description The Senior Stars Improvement, Clinical Professional responsible for the development, implementation and ..
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 ..
Job Information Humana Provider Engagement Clinical Executive - Remote FL in Tampa Florida Description The Provider Engagement, Clinical Executive develops and grows positive, long-term relationships with physicians, providers and healthcare systems ..
... ensure The Florida Agency for Healthcare Administration benchmarks, goals and deliverables ... reporting and analysis Understanding of healthcare quality measures such as CAHPS, ... members have absolute and continuous..
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 Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..
Job Information Humana Financial Reporting Lead in Tampa Florida Description The Financial Reporting Lead prepares and distributes periodic financial statements for users other than those directly employed by the organization. The ..
Description This is a salaried exempt position with responsibility for utilization management oversight and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in the TRICARE Operations Manual Chapter ..
Job Information Humana Utilization Management Nurse Lead - Remote FL in Tampa Florida Description The Utilization Management Nurse Lead utilizes clinical nursing skills to support the coordination, documentation and communication of ..
Job Information Humana Pre-Authorization Nursing Supervisor - Remote Florida in Tampa Florida Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Tampa Florida Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
... limited to, health insurance, data privacy/security/use, artificial intelligence, primary care, clinical ... 5 or more years of healthcare policy experience including a track ... research, and resource development supporting..
Job Information Humana Health Services Compliance Manager - Remote FL in Tampa Florida Description The Manager, Compliance (UM) conducts and summarizes compliance audits. The Manager, Compliance (UM) works within specific guidelines ..
Job Information Humana Senior Compliance Nurse - Remote FL in Tampa Florida Description The Senior Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description The Genetic Counselor 2 responsible for evaluating and understanding member's risk of inherited medical condition. The Genetic Counselor 2 work assignments are varied and frequently require interpretation and independent determination ..
Description Responsibilities The ACD Referral Authorization Coordinator Lead role will assist the Supervisor in oversight & monitoring of processing and timeliness standards for referrals and authorizations under the Autism Care Demonstration ..
Description The Care Management Support Assistant 2 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Tampa Florida Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese and ..
