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Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review of ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that ... to support optimal reimbursement. The Nurse Auditor 2 work assignments are ... Humana is looking for a..
... health (BH)/Substance Use Disorder (SUD) clinical quality performance measures to achieve ... Professional is responsible for improving clinical quality improvement and performance improvement ... Corporate based) such as BH..
... care management. The CMSS provides non-clinical support to the assessment and ... assignments. CMSS's work collaboratively with clinical support associates, (including nurses and ... customers (members), business partners, and..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... administration determinations. The Utilization Management Nurse 2 work assignments are varied ... action. Responsibilities The Utilization..
... Information Humana Care Manager, Telephonic Nurse 2 Certified Diabetes Care and ... bridge the gap and integrate clinical and self-management aspects of diabetes ... Humana is seeking a Registered..
... Responsibilities Be part of our Clinical Support Team - Humana is ... - Humana is seeking a Clinical Consultant who will be accountable ... results. Humana is seeking a..
... Coordinator 2 that will provide non-clinical support for the policies and ... UM Administration Coordinator 2 provides non-clinical support for the policies and ... members and/or providers to verify..
... uses advanced data analytic techniques, clinical acumen and operational insights to ... work at home anywhere Humana's Clinical Analytics and Trend (CAT) team ... needs your healthcare, analytic, and..
... the development of our innovative clinical data products, focusing on data-driven ... data products, focusing on data-driven clinical insights using the latest cloud ... vision and product roadmap for..
Description The RN Clinical team is looking for a ... looking for a dynamic Registered Nurse to join the team working ... will be someone who applies clinical and coding..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for ... without direction. Responsibilities Senior Pre-Authorization Nurse: Serves as a team lead ... with questions and mentoring of clinical staff..
... reviews for requested services using clinical judgment and refers to internal ... processes. Enters and maintains pertinent clinical information in various medical management ... policies. Required Qualifications Active Registered..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of ..
Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. Responsibilities The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate ..
... Information Humana Care Manager, Telephonic Nurse 2-Remote (Eastern Standard Time) in ... Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, ... members. The Care Manager, Telephonic..
