Healthcare Risk Manager Jobs

Job Information Humana Manager, Behavioral Provider Contracting in Dover Delaware Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and facilities. Analyzes ..

Description The Manager, Provider Contracting manages a team of dental recruiters that initiates, negotiates, and executes dental provider contracts and agreements in alignment with the specialty growth strategy. The manager provider ..

Description Responsibilities The Associate Director Medical/Financial Risk Evaluation leads a few powerful teams dedicated to reducing waste and abuse in the health care industry and its impacts on Humana. These teams ..

Description The Risk Management Professional 2 a critical ... member within Humana's Third Party Risk Management Program (TPRM), a 2nd ... our program by implementing vendor risk management practices and..

Description The Manager, Risk Adjustment oversees coding educators and ... and Medicaid Services (CMS). The Manager, Risk Adjustment works within specific guidelines ... schedules and goals. Responsibilities The Manager, Risk..

Job Information Humana Manager, Behavioral Provider Contracting - Remote in Dover Delaware Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and ..

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..

... Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in ... in Dover Delaware Description The Risk Management Professional 2 identifies and .....

Description Humana Medicaid is growing and you have the unique opportunity to grow with us! Join our team and propel Humana forward to solve the technology challenges of tomorrow. You'll collaborate ..

Description The Risk Management Professional 2 a critical ... member within Humana's Third Party Risk Management Program (TPRM), a 2nd ... our program by implementing vendor risk management practices and..

... Finance M&A Integration Senior Project Manager in Dover Delaware Description Humana's ... Finance M&A Integration Senior Project Manager to drive project-oriented duties related ... Finance M&A Integration Senior Project..

Job Information Humana Medicare/Medicaid Program Manager -- Remote in Dover Delaware ... looking for an experienced Program Manager (internally known as an Acquisition ... contracts. As a Medicaid/Medicare Program Manager..

... Information Humana AVP, Stars and Risk Adjustment National Medical Director in ... in Dover Delaware Description The Healthcare Quality Reporting & Improvement (HQRI) ... national planning and operations for..

... Humana Telephonic Behavioral Health Care Manager in Dover Delaware Description The ... Description The Behavioral Health Care Manager, in a telephonic environment, assesses ... members. The Behavioral Health Care..

Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..

Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness by guiding members/families toward resources appropriate for the ..

... preference with judicious use of healthcare resources Educates physicians regarding InterQual ... and coordinating patient care for high-risk patients across the healthcare continuum. Ensures the delivery of ... is..

Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..

Job Information Humana Manager, Fraud and Waste-Remote US in ... in Dover Delaware Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..

Description The Manager, STARS Improvement develops, implements, and ... Stars improvement team. Responsibilities The Manager, STARS Improvement develops the programs ... collaborative relationships with Provider Engagement, Risk Adjustment, and Clinical..

... Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership ... in Dover Delaware Description The Healthcare Quality Reporting & Improvement (HQRI) ... that leads Humana's Stars and..

Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Government. Responsibilities The Telephonic Care Manager will..

Job Information Humana Senior Medical/Financial Risk Clinical Professional in Dover Delaware ... Delaware Description The Senior Medical/Financial Risk Clinical Professional is responsible for ... implementation and monitoring of medical/financial risk...