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... Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, ... to grow, the National Medicaid Clinical Operations team is expanding our shared services .....
... guarantees while focusing on improving clinical and financial outcomes for the ... while also leading both MM team and cross-functionally to gain alignment ... Appeals, and Experience and Optimization..
... to grow, the National Medicaid Clinical Operations team is expanding our shared services ... services organization to enhance the clinical delivery process. The Associate Director, ... and operational metrics..
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... intent to create a transformative clinical model to serve their members ... as a change agent and lead all activities for the Company. ... part of the IT leadership..
Description The Clinical Pharmacy Lead monitors drug development pipeline, and ... and medical literature, while providing clinical support for internal stakeholders. Utilizes ... and improve health outcomes. The Clinical Pharmacy..
... with internal knowledge leaders and lead cross-functional stakeholders to gather business ... marketable products and capabilities. They lead, plan and track all phases ... role in identifying opportunities and..
... Director, Utilization Management Nursing utilizes clinical nursing skills to support the ... to grow, the National Medicaid Clinical Operations team is expanding our shared services ... services organization to..
... NAL employees assistants that are non-clinical and nurses that are Registered ... to act as an overall clinical concierge. The NAL Telephonic Assistant ... assigned. Provide accurate and appropriate..
... Develop strategic initiatives for overseeing clinical integrity, especially for utilization and ... of the Behavioral Health programs. Lead audit reviews of the behavioral ... developing standards of care and..
... of Accreditation to manage a team of subject matter experts on ... compliance with NCQA standards, manage team workload and work assignments, and ... strategic mindset. Responsibilities Leads a..
... and monitoring compliance while challenging team members to engage with and ... presentations. Demonstrated ability to effectively lead productive complex teams. Strong influencer, ... effectively with Hospital leadership, and..
... Information Humana Manager, Utilization Management RN - Remote in Washington District ... Manager, Utilization Management Nursing utilizes clinical nursing skills to support the ... and experience - Utilization Management..
... NAL employees assistants that are non-clinical and nurses that are Registered ... to act as an overall clinical concierge. The NAL Telephonic Nurse ... intervention Provide accurate and appropriate..
... background to create and oversee clinical strategy for the Group Medicare ... for the implementation of regional clinical programs and strategies, as well ... to deliver insights re: Humana..
... Manager, Utilization Management Nursing utilizes clinical nursing skills to support the ... individuals. Our leaders are passionate clinical leaders that have a strong ... Care model is preferred. Utilizing..
... healthcare leader to join our team as Associate Vice President, Utilization ... homecare services, and will utilize clinical skills to support the coordination, ... healthcare leader to join our..
... Pre-Authorization Nurse: Serves as a team lead and subject matter expert (SME) ... with questions and mentoring of clinical staff Reviews and resolves escalated ... reviews for requested services..
... Specific Information Dialysis experience required RN license required Full-time role PURPOSE ... PRINCIPAL DUTIES AND RESPONSIBILITIES: Utilizes clinical judgment, independent analysis, critical thinking ... company, department, program policies and..
... their health partners. Humana's Enterprise Clinical Operating Model (ECOM), is a ... outcomes through better integrating Humana's clinical capabilities, processes, and technology. This ... across Humana Responsibilities The Director,..
... to grow, the National Medicaid Clinical Operations team is expanding our shared services ... services organization to enhance the clinical delivery process. The National Medicaid ... The National Medicaid..
... experienced Senior Product Manager to lead the development of our innovative ... the development of our innovative clinical data products, focusing on data-driven ... data products, focusing on data-driven..
... Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE ... Description The Associate Director of Clinical Audit, Payment Integrity uses their ... Audit, Payment Integrity uses their..
