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Description The Clinical Programs Pharmacist integrates programs developed ... prescription drugs. The Staff RX Clinical Programs Pharmacist work assignments involve ... variable factors. Responsibilities Job Title: Clinical Programs Pharmacist Location:..
Description The Staff RX Clinical Programs Pharmacist integrates programs developed ... prescription drugs. The Staff RX Clinical Programs Pharmacist work assignments involve ... factors. Responsibilities Job Title: Part-Time Clinical Programs..
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..
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 ..
Description The UM Administration Coordinator 1 contributes to administration of utilization management. The UM Administration Coordinator 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. Responsibilities The ..
Description Humana's recently created Clinical Resource Team is looking to ... Do you have a solid clinical background in acute care? Well, ... Auditor opportunity with Humana. Performs clinical audit/validation..
Description The Doctor Call Queue Pharmacist will: Provide resolution or outreach for a resolution on prescriptions that are considered incomplete, invalid, or contain clinical issues preventing the fulfillment of the request ..
... the role will support Humana Clinical Pharmacy Review (HCPR) as a ... UM Administration Coordinator 1 provides non-clinical support for the policies and ... Job Description Summary The Rx..
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..
... 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..
Description The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request ..
Description The Staff RX Clinical Programs Pharmacist integrates programs developed to improve overall health outcomes with a focus on prescription drugs. The Staff RX Clinical Programs Pharmacist work assignments involve moderately ..
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 assignments ..
Description The UM Administration Coordinator 1 contributes to administration of utilization management. The UM Administration Coordinator 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. Responsibilities Job ..
... 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 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 ..
... 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..
Description Humana is looking for an experienced EAP Counselor that truly enjoys helping those in need within a call center environment. Our EAP Counselor's provide ongoing and crisis intervention counseling focused ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
