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... acumen to solve for the healthcare challenges of today. The Clinical ... team uses advanced scientific techniques, data analysis, forecasting, and clinical acumen ... various analytical organizations to lead..
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... The Director, Strategy Advancement provides data-based strategic direction identifying and delivering ... set on transforming the US healthcare system and making real improvements ... Medicare and Medicaid), by leveraging..
... through the collection of market data and internal analysis, with a ... infrastructure. Contribute to creation of top-quality presentations for senior leadership on ... and make recommendations from complex..
Description The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... system tools and database or data warehouse queries and scripts. In ... the analysis of..
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 ..
... and available resources to promote quality, cost-effective outcomes. Coordinate medical, behavioral ... ACD policy, provide outcome measure data to respective providers; serve as ... ensure care coordination assistance. Ensure..
... policy requirements. Ensure provision of quality patient care while maintaining cost-effective ... where analysis of situation or data requires evaluation of a variety ... for supporting and driving FMS..
Job ID 21000GJFAvailable Openings 1Position Specific Information Dialysis Experience Required PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program ..
... acumen to solve for the healthcare challenges of today. The Clinical ... team uses advanced scientific techniques, data analysis, forecasting, and clinical acumen ... their skills to assist with..
... Sr. Consumer Experience Professional performs data analysis supporting learning plans via ... consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional ... the analysis of situations or..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... leverages its advanced knowledge of data, modeling, optimization, and tools. Applies ... that improve the outcomes and quality of the programs we offer. ... operates. Understands and analyzes complex..
... to build a world class Data Science and Insights enterprise capability ... Through the strategic interpretation of data, we provide our consumers-physicians, patients, ... and analyzing diverse types of..
... relationships with physicians, providers and healthcare systems in order to support ... support and improve financial and quality performance within the contracted working ... the analysis of situations or..
Job ID 21000GNLAvailable 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 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 ..
... Member Plan (EFMP), auditing for quality and clinical compliance, and case ... entry and review of CDRL data pertaining to the ACD. Review ... compliance with ACD. Monitor for..
... the analysis of situations or data requires an in-depth evaluation of ... recommend opportunities to optimize vendor quality Facilitate the measurement of success ... and/or service level oversight including..
... Market Research Professional 2 performs data analysis supporting learning plans via ... consumer behavioral, demographic, and attitudinal data. The Market Research Professional 2 ... Market Research Professional 2 uses..
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 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 Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
