Healthcare Quality Data Analyst Jobs in South Carolina

Description The Partners in Primary Care (PiPC) Medical Coder conducts review of medical records to apply medical codes (ICD10, CPT, CPTII) for professional services that will be submitted to payers. The ..

... 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..

Description The Medical Coding Auditor Supervisor handles a combination of tasks, including extracting clinical information from a variety of medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, ..

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 ..

... 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..

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..

... 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..

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 ..

Job ID 21000G76Available 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 ..

Job ID 21000CDQAvailable 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 ..

... 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..

... 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..

Description Responsibilities The Quality Improvement Lead provides strategic leadership ... for Humana's South Carolina Medicaid Quality Program, in alignment with organizational ... Program, in alignment with organizational quality and population..

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 ..

Job ID 21000F3OAvailable Openings 2 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 Medical Coding Auditor Supervisor handles a combination of tasks, including extracting clinical information from a variety of medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, ..

... 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..

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..

Job ID 21000EQKAvailable 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 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 ..

... 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..

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 ..