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Description The Director, Health Services utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health Services requires an in-depth understanding ..
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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 ..
... processing operations and systems. The Director, Claims Oversight plays a vital ... relate to claims. Responsibilities The Director, Claims Quality Audit will oversee ... exceptional results to the TRICARE..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in Pittsburgh Pennsylvania Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a ..
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 ..
Description The Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
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 ..
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 ..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
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 CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania ... Pittsburgh Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
Description The Lead Product Manager for Specialty products leads all phases of the product life cycle for Dental, Vision and Life products, from inception to introduction into the marketplace. Responsibilities Position ..
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 Responsibilities The Associate Director for ACD Audit , at ... ACD Audit , at the director of the Director of Payment Integrity, will create ... optimizing operational processes. The..
... moderate to substantial. Responsibilities Humana Healthcare Research (HHR) needs your analytical ... tell a compelling story about healthcare today. Through the design and ... with meaningful real-life insights about..
We are in search of Direct Care Aide's to provide care and support for our clients with Intellectual and Developmental Disabilities. An employee in this class is responsible for the specialized ..
Job Information Humana Physician - CenterWell - Atlanta, GA in Pittsburgh Pennsylvania Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical ..
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 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 ..
!!!!!DIRECT CARE WORKERS NEEDED IMMEDIATELY!!!!!! We are in search of Direct Care Aide's to provide care and support for our clients with Intellectual and Developmental Disabilities. An employee in this class ..
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..
