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Description The Senior Quality Assurance, Clinical Professional requires being both a ... critical review judgment to make clinical determinations Knowledge of inpatient and ... Must demonstrate working knowledge of clinical..
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Description The Lead, Software Quality & Testing ensures that software products meet business standards, functional and non-functional requirements. The Lead, Software Quality & Testing works on problems of diverse scope and ..
Description The Quality Assurance, Clinical Professional 2 consults and collaborates ... and quality. The Quality Assurance, Clinical Professional 2 work assignments are ... you should strongly consider the Clinical Quality..
Job Information Humana Senior Provider Engagement Professional - Medicaid Prospective Programs Work at Home in Rogers Arkansas Description The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, ..
Job Information Humana UM Administration Coordinator 2 - Part Time - Work at Home (Friday-Sunday Schedule) in Rogers Arkansas Description (Friday - Sunday Schedule) The UM Administration Coordinator 2 contributes to ..
... 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..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Rogers Arkansas Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special Investigations ..
Job Information Humana UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Rogers Arkansas Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, DME, and ..
Job Information Humana Senior Medical Auditing Professional: REMOTE/WORK AT HOME in Rogers Arkansas Description The Senior Medical Coding Professional acts as the team SME (Subject Matter Expert) and provides training, guidance, ..
Job Information Humana UM Administration Coordinator (M-F or Tu-Sa Schedules Available) - REMOTE/WORK AT HOME (Anywhere in the US) in Rogers Arkansas Description The UM Administration Coordinator 2 contributes to administration ..
Description Do you enjoy helping those in need? Do you love researching, analyzing medical documents to determine if something was missed? Have you ever considered yourself a detective for medical claims ..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Rogers Arkansas Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Rogers Arkansas Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Job Information Humana UM Administration Coordinator 2 - Work at Home Thurs-Mon Schedule) in Rogers Arkansas Description (Thursday-Monday Schedule) The UM Administration Coordinator 2 contributes to administration of utilization management. The ..
... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG, clinical reference materials, internal teaching conferences, ... computer-based review of moderately complex..
... to be part of Humana Clinical technologies team !!! You have ... solutions for Humana Healthcare Services Clinical technology tea. An opportunity to ... opportunity to build and expand..
Description Lead, Technology Solutions (Clinical UM) The Lead, Technology Solutions ... strategic technology partner for Humana's clinical business areas including Clinical Operations (focusing on Utilization management), ... Operations (focusing on..
Job Information Humana Senior Network Strategy Professional-- REMOTE/WORK AT HOME (ANYWHERE IN THE US) in Rogers Arkansas Description The Senior Network Strategy Professional oversees various efforts involving complex data analysis and ..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work ... Rogers Arkansas Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug ... and medical literature, while providing clinical support for..
... part of Humana within the Clinical IT area. We are looking ... test data management program. The Clinical Test Data Quality Lead will ... responsible for modeling the multiple..