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Description The Director, Process Improvement analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Director, Process Improvement requires an in-depth understanding ..
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Description The Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... clinical delivery process. The Associate Director, Utilization Management..
Description As the Associate Director, IT Project Management, you will ... your background and experience in program management to lead and manage ... our Medicare segment. The Associate Director is..
Description The Director, Provider Reimbursement is responsible for ... team of associates. Responsibilities The Director, Provider Reimbursement develops and executes ... collaboration with other leaders, this Director will develop and..
Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
Description The Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Portland Maine ... Portland Maine Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
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 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 Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..
... commitment to the Quality Enhancement Program (QEP) and CQI Activities, including ... Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), ... There is a two-person assist..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Portsmouth New ... New Hampshire Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
