Healthcare Research Jobs in Portsmouth

... expertise within the realm of Healthcare Quality operations and improvement methodology, ... a subject matter expert in healthcare quality measurement, best practices, and ... Assurance (NCQA), the Agency for..

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..

... physicians, physician groups, and integrated healthcare delivery systems throughout the country. ... delivery systems throughout the country. Healthcare isn't just about health anymore. ... of our members, and the..

Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..

Job Information Humana Clinical Analytics and Trend Program Manager in Portsmouth New Hampshire Description The Clinical Strategy and Practice Lead builds strategies for development, engagement, best clinical practices and processes for ..

Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..

Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..

Description The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work assignments are ..

... strategic product extensions, and translates research discoveries into marketable products. This ... insights Bachelor's degree in Business, Healthcare Administration or other related fields ... 50 market leader in integrated..

Description The Senior Clinical Pharmacy Advisor - Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high performing team that helps ..

Description The Staff Clinical Pharmacist manages the formulary processes for the Clinical Formulary Administration team for the Medicaid LOB. The Staff Clinical Pharmacist work assignments involve moderately complex to complex issues ..

Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, ..

Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..

Description The Senior Claims Research & Resolution Professional manages claims ... the organization. The Senior Claims Research & Resolution Professional work assignments ... Responsibilities Description The Senior Claims Research &..

Job Information Humana Actuary, Risk and Compliance in Portsmouth New Hampshire Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare ..

Description The Provider Contracting Professional 2 initiates, negotiates, and executes dental provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied ..

Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..

Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..

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 ..

Description The Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..

Description The Experience Strategy & Transformation Lead enhances the consumer experience by architecting experiences and building capabilities that will positively impact our customers. The Experience Strategy & Transformation Lead works on ..

Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Professional works on problems ..

Description The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high ..