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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
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 ..
... District Of Columbia Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
... functions as directed by the Manager as necessary The Coordinator will ... of the Business & Operations Manager for the Department of Transport ... (Required) AndBasic Life Support for..
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 ..
... & 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..
Description The Senior Nursing Quality Outcomes Coordinator will partner with Hospital Quality, Safety, Regulatory and Hospital Risk as well as all leaders within the Division of Nursing to oversee or lead ..
Description The Manager, Software Engineering codes software applications ... based on business requirements. The Manager, Software Engineering works within specific ... schedules and goals. Responsibilities The Manager, Software Engineering standardizes..
Job Information Humana Bilingual Quality Auditor in Washington District Of Columbia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of ..
Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Washington District Of Columbia Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for ..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... Provides support to the Nurse Manager for the managerial and leadership ... one of the nation's largest healthcare management companies. The GW School ... to provide the highest quality..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Washington District Of Columbia Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will ..
Job Information Humana Technical Product Manager - Remote in Washington District ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
Job Description Summary: Health is everything. At CVS Health, colleagues are committed to increasing access, lowering costs and improving quality of care. Millions of times a day, we help people on ..
Description The faculty dentist is responsible for the care of patients in the hospital and clinics, as well as research, educational and advocacy initiatives as determined by the Division Chief and/or ..
... the Patient Access Supervisor or Manager and provide patient services and ... cash receipts/collections and submit to manager.Ensure that quality registration work queues ... Mentoring and TrainingProvide input to..
Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
Clinical Dietician III (PRN | As Needed)','2300014Z','!*!Responsible for providing clinical nutrition services, including nutrition assessment, modified diet formulation, self-management training and nutrition intervention to patients/residents. Ensures patient satisfaction, quality care, regulatory ..
