Clinical Jobs in Dover

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..

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..

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..

... 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..

... 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 Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Dover Delaware Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special Investigations ..

... 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 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 ..

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

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

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 - Part Time - Work at Home (Friday-Sunday Schedule) in Dover Delaware Description (Friday - Sunday Schedule) The UM Administration Coordinator 2 contributes to ..

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

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

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

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

... 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..

... 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..

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

... 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 UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Dover Delaware Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, DME, and ..