Clinical Jobs

... Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... action 3-5 years of prior..

Description The Senior Stars Clinical Professional (RN) works through phone calls and other outreach methods with members, providers, and/or vendors to close HEDIS care gaps. The Senior Stars Clinical Professional work ..

Description The Senior Stars Improvement, Clinical Professional responsible for the development, ... Program. The Senior Stars Improvement, Clinical Professional work assignments involve moderately ... Responsibilities The Senior Stars Improvement, Clinical..

... give guidance around operational and clinical best practices in the risk ... with market operations, finance and clinical team to effectively influence a ... give guidance around operational and..

Job Information Humana Credentialing Professional - Work At Home in Colorado Springs Colorado Description The Credentialing Professional obtains and reviews documentation to determine status in a health plan. The Credentialing Professional ..

Job Information Humana UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Colorado Springs Colorado Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, DME, ..

Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Colorado Springs Colorado Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..

Job Information Humana UM Administration Coordinator 2 - Part Time - Work at Home (Friday-Sunday Schedule) in Colorado Springs Colorado Description (Friday - Sunday Schedule) The UM Administration Coordinator 2 contributes ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Colorado Springs Colorado Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..

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..

... 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..

Job Information Humana Senior Provider Engagement Professional - Medicaid Prospective Programs Work at Home in Colorado Springs Colorado Description The Senior Provider Engagement Professional develops and grows positive, long-term relationships with ..

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 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..

Job Information Humana UM Administration Coordinator (M-F or Tu-Sa Schedules Available) - REMOTE/WORK AT HOME (Anywhere in the US) in Colorado Springs Colorado Description The UM Administration Coordinator 2 contributes to ..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Colorado Springs Colorado Description Humana is looking for an experienced Healthcare Investigator to join its ..

Job Information Humana Senior Network Strategy Professional-- REMOTE/WORK AT HOME (ANYWHERE IN THE US) in Colorado Springs Colorado Description The Senior Network Strategy Professional oversees various efforts involving complex data analysis ..

Job Information Humana Senior Medical Auditing Professional: REMOTE/WORK AT HOME in Colorado Springs Colorado Description The Senior Medical Coding Professional acts as the team SME (Subject Matter Expert) and provides training, ..

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 DRG Validation Auditor: REMOTE/Work At Home (Anywhere in the US) in Colorado Springs Colorado Description The DRG Validation Auditor extracts clinical information from a variety of medical records ..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work ... Springs Colorado Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug ... and medical literature, while providing clinical support for..

Job Information Humana UM Administration Coordinator 2 - Work at Home Thurs-Mon Schedule) in Colorado Springs Colorado Description (Thursday-Monday Schedule) The UM Administration Coordinator 2 contributes to administration of utilization management. ..