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... the claims processing and financial management functions are outsourced to an ... processing operations and systems. The Director, Claims Oversight plays a vital ... claims operations, claims systems change..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... a personalized, seamless and easy..
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Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... factors. Responsibilities Job Title: Medical Director Location: Work..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to ... key technology platforms/applications. The Associate Director, Problem, Incident and Event Management requires a solid understanding..
... is responsible for client cost management and satisfaction. The CAM is ... an account or branch for quality assessment and process improvement to ... with the goal of ongoing..
Description The Associate Director, Quality Assurance for Humana/Your Home Advantage ... programs to establish and maintain quality standards of existing products and ... Home Wellness Assessments. The Associate Director, Quality..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... Responsibilities Job Profile The Medical Director actively uses..
Description Responsibilities The Utilization Management Nurse 2 will be responsible ... on medical record documentation for quality and clinical compliance with contract ... for this position . 75% Quality Monitoring..
Description The Utilization Management Behavioral Health Professional 2 utilizes ... benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... a Compact State The Utilization Management Behavioral Health..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director provides medical..
Description Humana's National Medicaid Quality team is seeking a Market ... for supporting individual Medicaid market quality teams and serving as the ... the corporate level National Medicaid Quality team..
Description The Utilization Management Behavioral Health Professional 2 utilizes ... benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work ... of action. Responsibilities The Utilization Management Behavioral Health..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
Description The Medical Director actively uses their medical background, ... work. Responsibilities Title: Commercial Medical Director Location: Work At Home - ... weeks. Job Summary The Medical Director's work includes..
Description Responsibilities The Associate Director for ACD Audit , at ... ACD Audit , at the director of the Director of Payment Integrity, will create ... optimizing operational processes. The..
Description Humana's Enterprise Clinical Management team needs your clinical, business ... acumen to solve for the healthcare challenges of today. The Clinical ... Title : Clinical Trend Medical Director Assignment:..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Glen Allen ... Allen Virginia Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... waste,..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations ... Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for..
Description The Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
Description The Director, Health Services utilizes clinical nursing ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... segment. Responsibilities The SC Medicaid Director, uses clinical knowledge,..
Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
Description The Medical Director relies on medical background and ... reviews health claims. The Medical Director work assignments involve moderately complex ... variable factors. Responsibilities The Medical Director actively uses..
