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... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... customer service. The Clinical Account Manager (CAM) is directly responsible for ... assigned client(s). The Clinical Account..
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 ..
... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... an account or branch for quality assessment, education and clinical training, ... with the goal of ongoing..
Job Information Humana Technical Product Manager - Remote in Pittsburgh Pennsylvania ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
... whether services provided by other healthcare professionals are in agreement with ... training in transitions of care, quality assurance, utilization management and care coordination ... focusing on transitions of..
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 Description : JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate resource utilization, identification of opportunities ..
Job Information Humana Quality Improvement Program Lead (National Medicaid ... Improvement Program Lead (National Medicaid Quality) in Pittsburgh Pennsylvania Description Humana ... Healthy Horizons is seeking a Quality Improvement Program..
... 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..
Description The Vendor Quality Medical Director will manage clinical ... Director will manage clinical vendor quality outcomes for Humana Clinical Operations ... Director to manage clinical vendor quality outcomes for..
... access, lowering costs and improving quality of care. Millions of times ... addition to supporting the Pharmacy Manager in leading and directing your ... Practice • Regulatory Requirements •..
... This position reports to the Manager of Risk Adjustment Coding. As ... staff with opportunities for improved quality, risk adjustment coding performance. The ... Minimum Education: Associate degree in..
... in Pittsburgh Pennsylvania Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician..
... Planning - Medical Communications – Healthcare Communications- Medical Affairs This is ... and relationship building Mentoring, directing, quality control/quality assurance of junior staff members work ... Virology, HCV, Hepatitis..
... in Pittsburgh Pennsylvania Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) relies ... guidance to ensure..
Job Information Humana Associate Director, Site Reliability Engineering in Pittsburgh Pennsylvania Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, Site ..
About this job Find your commute UPMC Presbyterian is hiring a Medical Lab Scientist ( Medical Technologist) or Medical Lab Technician to support the Microbiology Lab! This role will work a ..
Description The Manager, Risk Adjustment oversees coding educators ... Adjustment oversees coding educators and quality assurance audits of medical records and ... and Medicaid Services (CMS). The Manager, Risk Adjustment..
Job Information Humana Bilingual Quality Auditor in Pittsburgh Pennsylvania Description ... Pittsburgh Pennsylvania Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..
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..
Description The Manager, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The Manager, Compliance Nursing works within specific ... schedules and goals. Responsibilities The Manager, Compliance Nursing ensures..
