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Description The Senior Medical/Financial Risk Evaluation Professional is responsible for supporting the development, implementation and monitoring of medical/financial risk. The Senior Medical/Financial Risk Evaluation Professional work assignments involve moderately complex to ..
Description Humana's National Medicaid Quality team is seeking a Market Consultant to be responsible for supporting individual Medicaid market quality teams and serving as the main relationship broker and liaison to ..
... serves as a Humana Military liaison to TRICARE beneficiaries, providers and ... unrestricted license to include: Licensed Clinical Social Worker (LCSW), Licensed Masters ... Licensed Masters Social Worker (LMSW-ACP),..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... and coding, organizational capabilities and clinical care delivery. Responsibilities The Associate ... ensures timeliness and production of clinical coding team, reviews escalation cases ... cases and oversees audits monitors..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Description The Senior Clinical Strategy and Practice Professional builds ... strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The ... within the enterprise..
... (EFMP), auditing for quality and clinical compliance, and case management. Serve ... a Humana Military/Humana Behavioral Health liaison to TRICARE beneficiaries, guardians, personal ... documentation. Complete required audits of..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
... patient care while maintaining cost-effective clinical operations in accordance with all ... and administrative policies as the clinical leader, has the authority to ... and regulations. Ensures all FMS..
