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Description Humana's Lead Program Integrity Investigator will oversee the ... waste, and abuse (FWA) compliance program to prevent and detect potential ... in Oklahoma to increase Medicaid program transparency and..
Description The Medicaid Oklahoma Pharmacy Director monitors drug development pipeline, and ... health outcomes. The Medicaid Pharmacy Director works on problems of diverse ... only Humana's Oklahoma Medicaid Pharmacy Director..
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Description The Director, Health Services utilizes clinical nursing ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... function or segment. Responsibilities The Director, Health Services utilizes..
... closely with the market QI director on a frequent basis. Support ... efficiency of the market quality program. Ensure that the market quality ... expertise within the realm 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 ..
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..
... Summary The Medicaid Oklahoma Pharmacy Director monitors drug development pipeline, and ... health outcomes. The Medicaid Pharmacy Director works on problems of diverse ... only Humana's Oklahoma Medicaid Pharmacy..
... 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..
... 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..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Tulsa Oklahoma ... Tulsa Oklahoma Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
... 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..
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 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, 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 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, 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 ..
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 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 ..
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 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 ..
