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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,..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in Ridgeland Mississippi Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a ..
... 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..
... will work closely with the clinical education and market implementation teams under ... Subject Matter Expert (SME) on clinical value-based care practices and participate ... the training team. Maintain..
Job Information Humana Associate Director/Grievances and Appeals-Remote/Virtual in US in ... Ridgeland Mississippi Description The Associate Director, Grievances & Appeals manages client ... a comprehensive analytic review of clinical documentation..
... 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..
... 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..
Job Information Humana Lead Product Manager - Healthcare API in Ridgeland Mississippi Description The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is directly ..
Job Information Humana Regional Pharmacy Sales, VP in Ridgeland Mississippi Description Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the nation's ..
... 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..
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..
... and Risk Adjustment National Medical Director in Ridgeland Mississippi Description The ... and 3) contribute as a clinical industry representative. As a leader, ... (PST) that drives national provider..
... Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... this role you will: Complete..
... MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Ridgeland ... on medical background and industry-standard clinical / coding guidance to ensure ... ensure physician and healthcare provider..
Job Information Humana Director of Pharmaceutical Manufacturer Relations in ... in Ridgeland Mississippi Description The Director, Pharmaceutical Manufacturer Relations ensures the ... health outcomes of patients. The Director, Pharmaceutical Manufacturer..
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,..
... 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 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 ..
Description The Senior Quality Improvement Professional will focus organizational efforts on improving South Carolina Medicaid clinical quality performance measures to achieve optimal performance and quality for the Humana Healthy Horizons in ..
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..
Description The Behavioral Health Medical Director responsible for behavioral health care ... operations. The Behavioral Health Medical Director work assignments involve moderately complex ... Business's (HGB) Behavioral Health Medical Director..
... the recruitment process for new clinical staff. Assists with clinical orientation and on-going training of ... set forth in the FMS Clinical Services Clinical Training Manual(s), FMS policies and..
