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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,..
... Work tasks assigned in the clinical documentation system Work assigned UM ... alternative levels of care using clinical knowledge and benefit plan design ... alternatives, if appropriate by analyzing..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
Description The Medical Director actively uses their medical background, ... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG, clinical reference materials,..
Job Information Humana Physician - CenterWell - Atlanta, GA in Green Bay Wisconsin Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care ..
... MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Green ... on medical background and industry-standard clinical / coding guidance to ensure ... ensure physician and healthcare provider..
... and Risk Adjustment National Medical Director in Green Bay Wisconsin Description ... and 3) contribute as a clinical industry representative. As a leader, ... (PST) that drives national provider..
Job Information Humana Director of Pharmaceutical Manufacturer Relations in ... Green Bay Wisconsin Description The Director, Pharmaceutical Manufacturer Relations ensures the ... health outcomes of patients. The Director, Pharmaceutical Manufacturer..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director will provide..
Job Information Humana Associate Director/Grievances and Appeals-Remote/Virtual in US in ... Bay Wisconsin Description The Associate Director, Grievances & Appeals manages client ... a comprehensive analytic review of clinical documentation..
... in the role of Associate Director, Neighborhood Center. Neighborhood Centers are ... retail setting, to include health education and improvement programs, clinical support, health screenings, customer service ... across..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in Green Bay Wisconsin Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for ..
... to the National Medicaid Quality Director, and be responsible for the ... in improving operational process and clinical care quality in an effort ... related issues, process improvement, and..
... Adjustment Integrity Unit (RAIU) Associate Director works collaboratively across the enterprise, ... values. Responsibilities The RAIU Associate Director is directly responsible for the ... and abuse, as well as..
... innovations, flexible medication access, one-on-one clinical support, and excellent customer service. ... customer service. Responsibilities Summary The Clinical Liaison is directly responsible for ... with their assigned client(s). The..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization ... resources which may include national clinical guidelines, Humana contract language, Humana ... and determinations, medical necessity criteria, clinical..
Job Information Humana Regional Pharmacy Sales, VP in Green Bay Wisconsin Description Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the ..
Job Information Humana Lead Product Manager - Healthcare API in Green Bay Wisconsin Description The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is ..
Description The Associate Director, Operational Readiness ensures optimized interaction between a company and members through the development of predictable and sustainable readiness practices including continuous improvement methodologies that allow for rapid ..