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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 ..
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 ..
Job Location Santa Maria DRC (CA) - Santa Maria, CA Position Type Full Time Education Level Bachelors Degree Travel Percentage None Job Shift Various Shift Hours Job Category Nonprofit - Social ..
The dedicated staff, highly-skilled physicians and surgeons, and advanced technology combine to make working at Los Alamitos Medical Center a personally-rewarding work environment. Nursing staff often hold advanced degrees, are dedicated ..
We’re a nonprofit, regional healthcare network with two hospitals, numerous outpatient medical offices, a multi-specialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer and emergency ..
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). ..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Torrance California Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage and ..
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 Associate Director, Quality Assurance for Humana/Your Home Advantage (YHA) develops and implements programs to establish and maintain quality standards of existing products and services pertaining to In Home Wellness ..
... of the MRA team, the Manager will work closely with market ... based on advanced knowledge/experience. The Manager, Risk Adjustment works within specific ... approach, resources, schedules and goals.The..
Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Torrance California Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end ..
... & 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..
PURPOSE AND SCOPE: Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure quality patient care ..
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 Technical Product Manager - Remote in Torrance California ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
PIH Health is a nonprofit regional healthcare delivery network founded over 50 years ago. Our two campuses including a 548-bed facility in Whittier and a 199-bed facility in Downey, help to ..
An exciting opportunity with an award-winning, Magnet Designated Hospital has just become available for Nurse Director of Quality Management. This is a great chance to lead a highly-skilled team and ..
Manager, Clinical Quality Review','21003CI',' At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians ..
