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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 ..
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 ..
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 ..
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..
Job Information Humana Telephonic Care Manager in Troy Michigan Description The ... Michigan Description The Telephonic Care Manager will be part of the ... coping skills. Responsibilities The Case Manager..
Description As the Associate Director, IT Project Management, you will use your background and experience in program management to lead and manage a team of PMO professionals that support the delivery ..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary. The PDC Care..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
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 Medical Director - Medicare Pharmacy Appeals in Troy Michigan Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Director of Compliance/HIPAA Privacy OfficernU.S. Medical Management (USMM) is an affiliate of a leading Fortune 100 company. A national organization built on a continuum of care with premier healthcare providers, clinicians ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Troy Michigan Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
... Information Humana Behavorial Economics Program Manager - Test & Learn Portfolio ... acumen to solve for the healthcare challenges of today. The Clinical ... years or more working in..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
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 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 ..
Description The Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
Description The Care Delivery Tele Sales Supervisor supports and develops a team of Care Delivery Tele Sales Agents. The Care Delivery Tele Sales Supervisor provides timely and effective support to assist ..
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, ..
Job Information Humana Clinical Analytics and Trend Program Manager in Troy Michigan Description The Clinical Strategy and Practice Lead builds strategies for development, engagement, best clinical practices and processes for clinical ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Troy Michigan Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..
Job Information Humana Senior Project Manager -- Remote in Troy Michigan ... Michigan Description The Senior Project Manager manages all aspects of a ... within budget. The Senior Project Manager..
