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Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Job Information Humana Manager, Pharmacy and Medical Trend in ... biosimilar pipeline process. Produce top quality presentations and reports to be ... Six Sigma, Lean (or other quality program) background..
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 ..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Dover ... Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible ... Member Plan (EFMP), auditing for quality..
Job Information Humana Technical Product Manager - Remote in Dover Delaware ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
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 Manager, STARS Improvement develops, implements, and ... Stars improvement team. Responsibilities The Manager, STARS Improvement develops the programs ... designed to increase the plan quality and partners with..
... acumen to solve for the healthcare challenges of today. The Clinical ... anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... progress and performance against the..
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..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Job Information Humana Quality Improvement Program Lead (National Medicaid ... Improvement Program Lead (National Medicaid Quality) in Dover Delaware Description Humana ... Healthy Horizons is seeking a Quality Improvement Program..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
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 Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
... Humana Nationwide Medicaid Behavioral Health Quality Lead in Dover Delaware Description ... Delaware Description The Behavioral Health Quality Lead will report directly to ... directly to the National Medicaid..
Job Information Humana Manager, Care Management Social Services-WAH Nationwide ... Description Job Description Summary The Manager, Care Management leads teams of ... multi-disciplinary care management team. The Manager, Care Management..
Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
