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The healthcare consultant will perform the following responsibilities: Conduct analysis of health plan and provider functional areas to identify impacts, opportunities and risks related to the implementation of ICD-10, create high ..
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Description The Senior Quality Engineer carries out procedures to ... and end-user requirements. The Senior Quality Engineer work assignments involve moderately ... variable factors. Responsibilities The Senior Quality Engineer performs..
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..
Description The Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
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 Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..
Description The Supervisor, Mail Order/OTC Pharmacy Distribution processes and dispenses or directly supports the processing and dispensing of Traditional and Over The Counter prescription orders to be mailed to patients' homes ..
Description The Director, Quality Improvement implements quality improvement programs for all lines ... and annual evaluation. The Director, Quality Improvement requires an in-depth understanding ... across departments. Responsibilities The Director,..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
... Our expanding organization wants compassionate healthcare professionals like you to help ... Summa Health System and Vibra Healthcare, is a state of the ... We are looking for dedicated..
Description The Market Research Professional 2 performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Market Research Professional 2 work assignments are ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
... the development and implementation of quality improvement interventions and audits and ... years of experience in Accreditation, Quality Management, Compliance, Utilization Management, Behavioral ... degree Advanced degree in a..
Description The Staff RX Clinical Programs Pharmacist integrates programs developed to improve overall health outcomes with a focus on prescription drugs. The Staff RX Clinical Programs Pharmacist work assignments involve moderately ..
Description The Staff Mail Operations Pharmacist licensed Pharmacist who is responsible for the accurate and timely dispensing of prescribed medication to patients. The Staff Mail Operations Pharmacist work assignments involve moderately ..
Description The Associate Director, Quality Improvement implements quality improvement programs for all lines ... annual evaluation. The Associate Director, Quality Improvement requires a solid understanding ... department(s). Responsibilities The Associate..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..
... Member Plan (EFMP), auditing for quality and clinical compliance, and case ... compliance with ACD. Monitor for quality standards, claims accuracy, fraud, and ... Qualifications BCBA (Board Certified Behavior..
Description The Dental Director (part-time) provides dental interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Responsibilities The ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
