Healthcare Process Analyst Jobs in Pittsburgh

Description The Director, Process Improvement analyzes, and measures the ... sustainable, repeatable and quantifiable business process improvements. The Director, Process Improvement requires an in-depth understanding ... or segment. Responsibilities The..

Description The Senior Risk Management Professional will be responsible for managing third party risk management (TPRM) work streams to support Humana's overall TPRM Program. Responsibilities include risk identification, data analysis, process ..

Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Pittsburgh Pennsylvania Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese and ..

Description The Clinical Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also pulls ..

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 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 ..

... for a Senior Business Systems Analyst to join working remote anywhere ... US! The Senior Business Systems Analyst performs analysis of business, process and user needs, documentation of .....

Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..

Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..

Description The Staff Consultative Pharmacist consults with patients, pharmacies and providers to provide patient care in the form of optimal medication therapy. The Staff Consultative Pharmacist work assignments involve moderately complex ..

Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..

Job Information Humana Healthcare Lead Product Manager: Hispanic Segment Medicare Advantage in Pittsburgh Pennsylvania Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Hispanic MA customer use. ..

Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..

Description The Actuarial Analyst 1, General provides actuarial support ... specific product lines. The Actuarial Analyst 1, General work assignments are ... moderate complexity. Responsibilities The Actuarial Analyst 1, General..

Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..

Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships ... goals. The Senior Value-Based Programs Analyst works on problems of diverse ... Responsibilities The Senior Value-Based Programs Analyst..

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 ..

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 ..

Job Information Humana Compliance Lead - Illinois Medicaid in Pittsburgh Pennsylvania Description The Compliance Lead ensures compliance with governmental requirements. The Compliance Lead works on problems of diverse scope and complexity ..

Description The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and ..

Description The Senior Product Manager conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of ..

... multiple priorities Commitment to continuous process improvement Exceptional verbal and written ... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural..

Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships ... Responsibilities The Senior Value-Based Financial Analyst advises executives to develop functional ... Qualifications Bachelor's degree in Business, Healthcare,..