Healthcare Qa Analyst Jobs

Description The Senior Quality Assurance, Clinical Professional requires being both a nurse/RN and a certified Coder nurse as this position will be cross trained to review DRG (Diagnosis Related Group) audits ..

Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..

Description The Senior Pharmacy Sales Executive leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions to Humana Pharmacy for fulfillment. The Senior Pharmacy Sales Executive ..

Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Colorado Springs Colorado Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the ..

Job Information Humana Technical Product Manager - Remote in Colorado Springs Colorado Description The Senior Product Management Professional/Technical Product Manager (TPM) must be able to lead, plan and track all phases ..

Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Colorado Springs Colorado Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage ..

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 ..

Job Information Humana UM Medical Director - Conviva in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..

Description The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and ..

Description This position is for Enclara Pharmacia, a Humana company. Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the nation's largest ..

Description Manages a team of coding educators and reports to Risk Adjustment Director. Responsible for implementing operational and clinical best practices in the risk adjustment methodology, understanding clinical suspects and appropriate ..

... & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US ... & Risk Management Quality Audit (QA) Risk Management Professional 2, you ... for executing the Compliance Oversight..