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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 Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..
Job Information Humana Healthcare Strategy Consultant in Colorado Springs ... Colorado Springs Colorado Description The Healthcare Strategy Consultant provides data-based strategic ... Responsibilities Humana, a Fortune 60 Healthcare Company Humana..
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 ..
Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..
... HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional ... HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional ... guidelines/procedures. Primary responsibilities for the..
... Information Humana Associate Vice President, Quality Improvement for Healthy Horizons in ... in the role of AVP, Quality Improvement for Healthy Horizons. Decisions ... related to accreditation, auditing and..
Job Information Humana Strategy Advisor, Healthcare Strategy in Colorado Springs Colorado ... Colorado Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..
... Humana members to make informed healthcare decisions. Our key goal is ... help our members obtain high quality, affordable healthcare while keeping our provider networks ... (cost) & Effectiveness..
... population health management, contract compliance, quality improvement, and pilot/value-based payment programs. ... and Responsibilities Lead clinical and quality management components of HGB's Integrated ... with effective implementation of the..
Description The Principal Quality Leader will lead testing and ... Leader will lead testing and quality collaboration between Business and IT, ... tools and assure adherence to quality standards. Serves..
Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..
Description The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... factors. Responsibilities The Senior Medicaid Quality Data and Reporting Analyst will be responsible for the..
Job ID 21000MS2Available Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Description The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization, with a focus on oncology requests. The Oncology ..
... Humana Nationwide Medicaid Behavioral Health Quality Lead in Colorado Springs Colorado ... Colorado Description The Behavioral Health Quality Lead will report directly to ... directly to the National Medicaid..
... Humana Lead Product Manager - Healthcare API in Colorado Springs Colorado ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - ... Horizons is seeking a Senior Quality Program Delivery Professional who will ... who will manage and support quality improvement..
Job Information Humana Senior Innovation Portfolio Strategy Professional in Colorado Springs Colorado Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives ..
Job Information Humana Senior Copy Writer in Colorado Springs Colorado Description Humana's The Hive is looking for a Senior Copy Writer to join the team! The Hive is Humana's in-house agency, ..
Description As a Data and Reporting Analyst, you will be responsible for generating reports and regular datasets for the Primary Care Organization (PCO) related to new patient growth. The Data and ..
Job Information Humana Quality Improvement Program Lead (National Medicaid ... Improvement Program Lead (National Medicaid Quality) in Colorado Springs Colorado Description ... Healthy Horizons is seeking a Quality Improvement Program..
