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... Health Facilities to obtain sufficient clinical information. The Utilization Management Behavioral ... Behavioral Health Professional 2 uses clinical knowledge and independent critical thinking ... five (5) years of post-degree..
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Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... Senior Market/Industry Insights Professional delivers clinical/medical policy insight and information to ... policy in order to complement clinical, cost and quality strategies. Meets ... other provider organizations to address..
... Work tasks assigned in the clinical documentation system Work assigned UM ... alternative levels of care using clinical knowledge and benefit plan design ... alternatives, if appropriate by analyzing..
... providers by implementing operational and clinical best practices in the risk ... the risk adjustment methodology, understanding clinical suspects and appropriate clinical documentation and accurate coding. This ... with..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Profile The Medical Director actively uses..
Job Information Humana Medicaid Associate Director, Compliance Nursing in San Antonio ... San Antonio Texas Description The Associate Director, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the ... and/or benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... to grow,..
Description The Medical Director actively uses their medical background, ... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG, clinical reference materials,..
... 41) market leader in integrated healthcare with a clearly defined purpose ... experience and vitality of the associate community. Through offerings anchored in ... we are seeking an experienced..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in San Antonio Texas Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for ..
Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates ... business acumen. Responsibilities As the Director of Product Management for Clinical Pharmacy Products, you will be..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
... closely with the market QI director on a frequent basis. Support ... expertise within the realm of Healthcare Quality operations and improvement methodology, ... measurement, and the improvement of..
... moderate to substantial. Responsibilities Humana Healthcare Research (HHR) needs your analytical ... tell a compelling story about healthcare today. Through the design and ... with meaningful real-life insights about..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director actively uses..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to ... acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Title: Medical Director Location: Work..
Description Responsibilities The Senior Clinical Insights Professional delivers clinical policy insight and information to ... Government Business (HGB). The Senior Clinical Insights Professional will draft and ... will draft and..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... a personalized, seamless and easy..
