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Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with an Inpatient Senior Medical Coding Auditor roles! This is a unique team that's primary role is to ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Medical Coding Auditor roles! This is a unique team that's primary role is to quickly ..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
... determinations, MCG, clinical reference materials, internal teaching conferences, and other reference ... work, communication of decisions to internal associates, and possible participation in ... educational materials Engages with key..
Description The Clinical Pharmacy Lead for Pharmacy trend will be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual ..
Description This position is for Enclara Pharmacia, a Humana company. Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the nation's largest ..
Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Dover Delaware Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and scope ..
Description Humana's Claims Cost Management (CCM) organization is seeking a Manager, Fraud & Waste to join the Provider Payment Integrity-Clinical Audit team working remote anywhere in the US. As the Fraud ..
Job Information Humana Manager, Pharmacy and Medical Trend in Dover Delaware Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and medical, ..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Dover Delaware Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing clinical ..
... the brand identity across all internal and external communications Collaborate with ... and present strategic concepts to internal marketing partners Translate business and ... culture with the agency team,..
... necessity criteria, clinical reference materials, internal teaching conferences, and other reference ... work, communication of decisions to internal associates, and possible participation in ... educational materials Engages with key..
Job Information Humana Clinical Pharmacy Lead, Remote in Dover Delaware Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Dover Delaware Description Humana is seeking an experienced management professional to lead an interactive multidisciplinary team that helps translate the clinical ..
Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..
Job Information Humana Associate Vice President, Quality Improvement for Healthy Horizons in Dover Delaware Description As a company whose primary focus is on the well-being of its members, Humana is dedicated ..
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 ..