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... exceptional results to the TRICARE Program. In this role you will: ... requirements related to the TRICARE Program related to claims processing. Ensure ... support compliance with the TRICARE..
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 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 ..
... acumen to solve for the healthcare challenges of today. The Clinical ... home anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... team Low Value Care..
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 ..
... commitment to the Quality Enhancement Program (QEP) and CQI Activities, including ... PCT’s. Collaborates with the Clinical Manager and Education Coordinator in driving ... Clearance Monitoring (OLC), Adequacy Monitoring..
Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will assess, plan, coordinate, implement, ... Care Management Team, the care manager..
... Humana Clinical Analytics and Trend Program Manager in Indianapolis Indiana Description The ... The Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... managers across the..
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 ..
Description The Field Care Manager NP assesses and evaluates member's ... of members. The Field Care Manager NP works on problems of ... substantial. Responsibilities The Field Care Manager NP..
Job ID 21000HFNAvailable Openings 1Position Specific Information 1594 E MAIN ST Danville, IN 46122 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... to administer the TRICARE health program for military members, retirees and ... through TRICARE and other military healthcare programs...
... your background and experience in program management to lead and manage ... of the segment PMO, ensuring staffing is appropriate to meet program and project needs, mitigating overall .....
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
... Adheres to the FMCNA Compliance Program, including following all regulatory and ... requirements of the FMCNA Compliance Program, and FMS patient care and ... results, including costs, methods, and..
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..
... to administer the TRICARE health program for military members, retirees and ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Discharge Call (PDC) Telephonic Care..
... compliance, and quality performance and staffing management. Detailed Responsibilities include: Leads ... Support development of national clinical staffing models and work with Medicaid ... with Medicaid markets to support..
... for Change Orders, for ACD Program Integrity Audit; driving to operational ... team to work with ACD Program Integrity leadership, develop new, or ... leadership, develop new, or change..
