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... acumen to solve for the healthcare challenges of today. The Clinical ... low value care and related healthcare resource waste, with a focus ... news and reports in the..
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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 ..
... Develop and monitor performance and quality of initiatives, providing insight and ... changes, be responsible for overarching project planning and deliverables for the ... lead development of meaningful QIPs..
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..
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..
... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the Healthcare Clinical Operations. After completion of ... Participates in corporate-wide committees Performs..
Description The Senior Quality Improvement Professional will focus organizational ... (BH)/Substance Use Disorder (SUD) clinical quality performance measures to achieve optimal ... to achieve optimal performance and quality for the..
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, 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 ..
... 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 Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
... 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 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 ..
Description The Senior Quality Improvement Professional will focus organizational ... on improving Kentucky Medicaid clinical quality performance measures to achieve optimal ... to achieve optimal performance and quality for the..
... policy requirements. Ensure provision of quality patient care while maintaining cost-effective ... for supporting and driving FMS quality standards through meeting all ESRD ... requirements and the practice of..
