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... section 4. Responsibilities The UM Manager will lead a team of ... guiding clinical decisions. The UM Manager will be responsible for workload ... distribution of the team. The..
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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 ..
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 Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... schedules and goals. Responsibilities The Manager, Care Management oversees..
... 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..
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 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 ..
... 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..
... the ACD policy requirements and Program Integrity policies, procedures and workflows ... Qualifications 3 plus years of healthcare fraud investigation experience 2 plus ... knowledge and experience Experience in..
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 ..
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 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 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..
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 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 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 ..
... 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..
... Humana Clinical Analytics and Trend Program Manager in Green Bay Wisconsin Description ... The Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... progress and performance..
... changes, be responsible for overarching project planning and deliverables for the ... for Change Orders, for ACD Program Integrity Audit; driving to operational ... team to work with ACD..
