THE LARGEST COLLECTION OF HEALTHCARE JOBS ON EARTH
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... to the State of Oklahoma business managing inquiries by conducting a ... arising under Humana's Oklahoma Grievance System, including enrollee grievances, appeals, State ... and claims-related disputes (the Grievance..
... measures the effectiveness of existing business processes and develops sustainable, repeatable ... develops sustainable, repeatable and quantifiable business process improvements. The Director, Process ... Director, Process Improvement researches best..
... as a focus on collaborative business relationships, value based care, population ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
... technological solutions to meet Medicaid business needs within a specified scope ... developing, guiding, and documenting clinical business system and functional processes, influences system design to optimize support and..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
Description The Clinical Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also pulls ..
... is look for a Senior Business Systems Analyst to join working remote anywhere ... in the US! The Senior Business Systems Analyst performs analysis of business, process and user..
... criteria in the Formulary Enterprise System Evaluates new medications and accurately ... Collaborates with other pharmacists and healthcare professionals in a team environment ... Manages and communicates line of..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Tulsa Oklahoma Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
... and executing on Humana's consumer-focused business strategy demands constant negotiation with ... and documentation within a tracking system. May assist with identifying and ... to ensure effective and efficient..
Job Information Humana Sr. Clinical Recruiter - VSP( Variable Staffing Pool) in Tulsa Oklahoma Description The Senior Recruiter interviews prospective employees for hourly and salaried positions. Assists with university graduate and ..
Description The Senior Product Manager conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of ..
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 ..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... report information for end-users using system tools and database or data ... Medicaid Quality Data and Reporting..
Job Information Humana Clinical Recruiter 2 - VSP in Tulsa Oklahoma Description The Clinical Recruiter 2 interviews prospective employees for hourly and salaried positions. Assists with Pharmacy recruiting from entry level ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
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 ..
