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... oversee our behavioral health (BH) clinical program for Medicaid plan members. ... the day-to-day administration and strategic management of behavioral and physical health ... physical health services, including utilization..
... The Your Home Advantage (YHA) Market Clinical Manager (MCM) will lead a ... In-Home Wellness Assessments (IHWA). The Market Clinical Manager provides leadership, clinical management and administrative oversight in..
... 50 years as a proven leader and innovator in the health ... self-employed individuals. Humana has a market leading Medicare Advantage and Medicare ... in developing a robust integrated..
... Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... to grow, the National Medicaid Clinical Operations team is expanding our ... services organization to enhance the..
... whose purpose is to provide care management program support resources to physicians, ... careers. At Partners in Primary Care, we're seeking innovative people who ... whole. Responsibilities CenterWell Senior..
... and coding, organizational capabilities and clinical care delivery. Responsibilities The Associate Director, ... ensures timeliness and production of clinical coding team, reviews escalation cases ... cases and oversees audits..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the ... determinations. The Associate Director, Utilization Management Nursing requires a solid understanding ... to grow, the..
... a $77 billion (Fortune 41) market leader in integrated healthcare with a ... are seeking an experienced healthcare leader to join our team as ... health outcomes and advancing..
... service activities through data integrity management and gathering of provider claims ... performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, ... to provider performance, member..
Description The Clinical Pharmacy Advisor lead, overseeing Humana ... team that helps translate the clinical into financial. The goals is ... Utilize broad understanding of managed care to develop strategies..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the ... administration determinations. The Manager, Utilization Management Nursing works within specific guidelines ... goals. Responsibilities The Manager,..
... Humana is a Fortune 60 market leader in integrated healthcare with a ... for seniors. As a OmniCare Clinical Care Product Management Lead focused on Medicare, Medicaid ... coordinating..
Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates ... As the Director of Product Management for Clinical Pharmacy Products, you will be ... Humana's Pharmacy-based..
... design and development of quality, clinical, population health programs, services, and ... Horizons CEO, serve on the market leadership team and liaise with ... to ensure alignment across the..
... will serve as the local market lead for accreditation compliance. The ... and investigations into quality of care concerns. This position has primary ... responsibility to operate a quality..
Description The Senior Clinical Pharmacy Advisor - Trend, is ... team that helps translate the clinical into financial. The goals is ... efforts through the collection of market data and..
... for improving the quality of care and outcomes while managing costs ... Housing challenges, Isolation, etc.) This leader will work collaboratively to deliver ... operational plans that address the..
... to grow, the National Medicaid Clinical Operations team is expanding our ... services organization to enhance the clinical delivery process. The National Medicaid ... The National Medicaid Director of..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product ... Product Strategy team. The Senior Clinical Business Professional work assignments involve ... at home anywhere..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to ... healthcare challenges of today. The Clinical Analytics and Trend team uses ... techniques, data analysis,..
... requested services, requested level of care, and/or requested site of service ... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG,..
Description The Senior Clinical Business Professional manages all aspects ... and within budget. The Senior Clinical Business Professional work assignments involve ... variable factors. Responsibilities The Senior Clinical Business Professional..
