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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 Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... schedules and goals. Responsibilities The Manager, Utilization Management Nursing..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
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 ..
... acumen to solve for the healthcare challenges of today. The Clinical ... home anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... progress and performance against..
... 8 or more years of project leadership experience Experience leading large ... oriented with excellent organizational and project management skills Demonstrated ability to ... improving consumer experiences Preferred Qualifications..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
... 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..
... As the Associate Director, IT Project Management, you will use your ... your background and experience in program management to lead and manage ... staffing is appropriate to meet..
... Humana Clinical Analytics and Trend Program Manager in Portland Maine Description The ... The Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... progress and performance..
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 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 Care Management Support Assistant 3 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
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 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 The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
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 Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..