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Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
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... resources, which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of moderately complex to complex..
Description The Clinical Pharmacy Advisor lead, overseeing Humana ... team that helps translate the clinical into financial. The goals is ... key metrics and trend. Support clinical research integration activities..
Job Information Humana Clinical Pharmacy Lead, Remote in Albuquerque ... team that helps translate the clinical into financial to ensure Humana ... to inform the financial and clinical significance of..
... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of moderately complex to complex..
Description The Senior Clinical Pharmacy Advisor - Trend, is ... team that helps translate the clinical into financial. The goals is ... Responsibilities include the following: Provide clinical and analytical..
... and concurrent reviews to identify documentation improvement opportunities according to CMS ... providers by implementing operational and clinical best practices in the risk ... the risk adjustment methodology, understanding..
Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Albuquerque ... team that helps translate the clinical into financial to ensure Humana ... and providers. The Director, Pharmacy Clinical..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work ... New Mexico Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug ... and medical literature, while providing clinical support for..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
... Information Humana Medicare Risk Adjustment Documentation and Coding Improvement Educator - ... providers by implementing operational and clinical best practices in the risk ... the risk adjustment methodology, understanding..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies ... HPS executive leaders, Trade Relations, Clinical, Analytics, Actuaries, and Operation functions ... strategies. Responsibilities The Director, Pharmacy Clinical Formulary..
Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..
Description The Clinical Pharmacy Lead for Pharmacy trend ... team that helps translate the clinical into financial to ensure Humana ... team that helps translate the clinical into financial to..
Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Albuquerque New ... Mexico Description The Senior Pharmacy Clinical Advisor will be part of ... to the development of..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
... innovation and strategies which optimize clinical outcomes, member experience and total ... will lead development of our clinical infusion strategy focused on our ... collaborate closely with the current..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Albuquerque New Mexico Description Humana is looking for an experienced Healthcare Investigator to join its ..