Director Healthcare Quality Management Jobs in Lancaster

Description Responsibilities The Senior Market/Industry Insights Professional delivers clinical/medical policy insight and information to both internal and external customers for Humana Government Business (HGB). The Senior Market/Industry Insights Professional will draft ..

... to complement utilization, cost and quality strategies. Meets regularly with the ... for multiple departments, especially utilization management and care management groups. Leverages clinical experience and ... Qualifications Bachelor's..

Description The Utilization Management Nurse 2 utilizes clinical nursing ... benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... RN licensed required The Utilization Management Nurse 2..

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..

... 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..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Lancaster South ... South Carolina Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... waste,..

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 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 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 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 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 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..

... 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..

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..

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 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 Responsibilities The Quality Improvement Lead provides strategic leadership ... for Humana's South Carolina Medicaid Quality Program, in alignment with organizational ... Program, in alignment with organizational quality and population..

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:..

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..

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 actively uses..

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. ..

... 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..