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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..
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 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 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 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 ..
... 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 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 ..
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, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of moderately complex to complex..
... 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..
