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... to the Vice President, Medical Management Operations and serves as a ... functions related to HGB's Care Management programs to include predictive models, ... corresponding support. Also leads Utilization..
Description The Care Management Support Assistant 3 contributes to ... contributes to administration of care management. Provides non-clinical support to the ... wellbeing of members. The Care Management Support Assistant..
... by virtue of our TRICARE contract in which we provide healthcare ... leader to join the Humana Government Business (HGB) team as Associate ... a renewal of the TRICARE..
... and possible participation in care management. The clinical scenarios predominantly arise ... health, or disease or care management. Medical Directors support Humana values, ... in teams focusing on quality..
Description Responsibilities The Utilization Management Nurse 2 will be responsible ... quality and clinical compliance with contract requirements as outlined in the ... codes. Our Department of Defense Contract requires..
Job Information Humana Provider Data Management & Contract Load Professional in Aberdeen South ... South Dakota Description Provider Data Management & Contract Load Professional 2 is responsible ... provider accounts...
... highly specialized professional associates. Our Government contract requires US CItizenship for this ... Engineering initiatives Team building and management Required Qualifications: Our Government contract requires US Citizenship for this..
Job Information Humana Vendor Management Lead (Remote US) in Aberdeen ... looking for an experienced Vendor Management Lead to join working remote ... in the US. The Vendor Management Lead..
Description Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..
Description CenterWell Pharmacy is seeking a pharmacy contracting professional to solicit and maintain network agreements for all pharmacy lines of business. The pharmacy contracting professional 2 will be responsible for contracting ..
Job Information Humana Manager, Compliance - Agent Investigation Unit in Aberdeen South Dakota Description The Manager, Compliance ensures compliance with governmental requirements. The Manager, Compliance works within specific guidelines and procedures; ..
Job Information Humana Senior Compliance Professional - Medicaid in Aberdeen South Dakota Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional's work assignments involve moderately complex ..
... include national clinical guidelines, Humana contract language, Humana coverage policies and ... and possible participation in care management. The clinical scenarios predominantly arise ... care, population health, and/or disease/care..
... and possible participation in care management. The clinical scenarios arise from ... health, or disease or care management. Medical Directors support Humana values, ... in teams focusing on quality..
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..
... of variable factors. Responsibilities Humana Government Business's (HGB) Behavioral Health Medical ... the day-to-day administration and strategic management of behavioral and physical health ... physical health services, including utilization..
Description Humana is seeking a pharmacy contracting professional to solicit and maintain network agreements for all pharmacy lines of business. The pharmacy contracting professional 2 will be responsible for contracting efforts ..
... includes data entry into medical management system, assigning an appropriate provider, ... diagnoses and/or referral requiring Case Management, and pend to appropriate point ... discretion. Our Department of Defense..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
... let your creative ideas, relationship management and sales ability shine? If ... the day-to-day selling and/or account management activity. Accountable for achieving new ... 3 years of strong relationship..
