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... 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 Are you a fit? Looking for an outstanding work environment and schedule? Want to practice pharmacy in an innovative setting? Do you seek an opportunity for professional growth with a ..
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 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 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 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 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 UM Administration Coordinator 3 contributes to administration of utilization management. The UM Administration Coordinator 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate ..
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 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 ..
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..
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 ..
Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied ..
... 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 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:..
... 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 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 Senior Stars Improvement Clinical Professional develops and grows positive, ... Responsibilities The Senior Stars Improvement Clinical Professional's work focuses on relationship ... improving provider/member outcomes related to 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 ..
