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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 ..
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, 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 Quality Improvement Program Lead (National Medicaid Quality) in Ridgeland Mississippi Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end ..
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 Ridgeland Mississippi Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage and ..
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 ..
... in Ridgeland Mississippi Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
... & 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 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 ..
Job Information Humana Associate Director, Site Reliability Engineering in Ridgeland Mississippi Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, Site ..
... in Ridgeland Mississippi Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
... and other members of the healthcare team to interpret, adjust, and ... Recommend disciplinary action to Clinical Manager and initiate as appropriate. Ensure ... the absence on the Clinical..
Job Information Humana UM Medical Director - Conviva in Ridgeland Mississippi Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
