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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 ..
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... for a Lead Cloud Product Manager to join our Enterprise Architecture ... Architecture team. The Lead Product Manager Conceives of, develops, delivers, and ... Responsibilities The Lead Cloud Product..
Description The Care Manager, Telephonic Nurse 2, in a ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... compact state The Transplant Care Manager, Telephonic Nurse..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Birmingham Alabama Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
... care, and/or requested site of service should be authorized. All work ... inpatient, post-acute care environments, outpatient service requests, ER review, pharmacy review ... whether services provided by other..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
... Humana is a Fortune 60 healthcare company with a history of ... developing a robust integrated care delivery model that integrates insurance with ... top place to work in..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
... vision, core values and customer service philosophy. Adheres to the FMCNA ... documentation completed for annual in service training, and policy and procedure ... and policy and procedure in..
Description The Associate Director, Quality Assurance for Humana/Your Home Advantage (YHA) develops and implements programs to establish and maintain quality standards of existing products and services pertaining to In Home Wellness ..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary...
Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
Description The Senior Product Manager - Fully Insured supports strategy ... Fully Insured supports strategy development, delivery, and management of the 100 ... business. Responsibilities The Senior Product Manager supports..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Government. Responsibilities The Telephonic..
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 ..
Description The Transplant Care Manager, Telephonic Nurse 2 , in ... of members. The Transplant Care Manager, Telephonic Nurse 2 work assignments ... home anywhere The Transplant Care Manager, Telephonic..
Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... schedules and goals. Responsibilities The Manager, Utilization Management Nursing..
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... schedules and goals. Responsibilities The Manager, Care Management oversees..
Description The Director, Health Services utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health Services requires an in-depth understanding ..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
