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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
... Humana is a Fortune 60 healthcare company with a history of ... 50 years as a proven leader and innovator in the health ... top place to work in..
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Job Information Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Military to be a thought leader in the industry and an ... and accreditation/regulatory standards during this..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or ..
... development and implementation of quality improvement interventions and audits and assists ... multiple priorities Commitment to continuous process improvement Exceptional verbal and written communication ... degree Advanced degree in..
Description The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 work assignments are varied and frequently ..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
... business Actively identifies and owns process improvements and operates with a ... reporting to ensure legislative and process adherence Develop and document processes. ... with leading end to end..
... physicians, physician groups, and integrated healthcare delivery systems throughout the country. ... delivery systems throughout the country. Healthcare isn't just about health anymore. ... of our members, and the..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
... overall end to end bid process at a leading Medicare Advantage ... Medicare bids. Create and maintain process improvements to bid filings to ... at least 1 year of..
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 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 Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
Description Responsibilities This position will maintain the Humana Military ACD website Autism Center of Excellence (CoE); ensuring educational information is current and relevant to training needs in addition to analyzing and ..
... Integrity, will create and implement process improvement plans focused on the beneficiary ... design and implementation of the process and experience for the ACD ... Associate Director will oversee..
... $77 billion (Fortune 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team as ... President,..
... that our members receive quality healthcare at an affordable price. You ... and recommendations Identify and suggest process improvement opportunities Develop and monitor team ... (RN) license 3 years..
Description The Staff Clinical Pharmacist manages the formulary processes for the Clinical Formulary Administration team for the Medicaid LOB. The Staff Clinical Pharmacist work assignments involve moderately complex to complex issues ..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
