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Description The Staff Clinical Pharmacist- Clinical Formulary Administration monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM..
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..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work..
Job Information Humana Senior Accreditation Professional in Brentwood Tennessee Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance..
Our Morristown location covers the following counties: Claiborne, Grainger, Cocke, Hamblen, Jefferson, Hancock SOME OF OUR PERKS: Daily pay Option Available! No need to wait until payday! We offer retention..
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..
Job Information Humana Actuary, Risk and Compliance in Brentwood Tennessee Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for..
