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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..
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..
... is committed to providing personalized, high-quality primary care combined with an ... in both the treatment and management of most chronic and acute-care ... based care provider focused on..
... delivery process. The National Medicaid Director of Clinical Strategy and Practice ... community within the enterprise. The Director of Clinical Strategy has direct ... responsibility for establishing the Care..
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 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..
... 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 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 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 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 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. ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Pittsburgh Pennsylvania ... Pittsburgh Pennsylvania Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... waste,..
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..
... Services is now hiring a Director of Rehab to oversee rehabilitation ... of our service locations! The Director of Rehab is responsible for ... regulatory compliance Ensures the clinical..
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 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 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 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 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..
... policy requirements. Ensure provision of quality patient care while maintaining cost-effective ... for supporting and driving FMS quality standards through meeting all ESRD ... requirements and the practice of..
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..
