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Description The Senior Policy Governance Professional policy Governance is the combination ... goals. The Senior Policy Governance Professional work assignments involve moderately complex ... Responsibilities The Senior Policy Governance Professional..
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Description The Senior Risk Management Professional identifies and analyzes potential sources ... minimize risk. The Senior Risk Management Professional work assignments involve moderately complex ... factors. Responsibilities The Senior Risk..
Description The Senior Clinical Business Professional manages all aspects of a ... budget. The Senior Clinical Business Professional work assignments involve moderately complex ... Responsibilities The Senior Clinical Business Professional..
... on medical background and reviews health claims. The Medical Director work ... and possible participation in care management. The clinical scenarios predominantly arise ... phone to gather additional clinical..
... The Care Manager, Telephonic Behavioral Health 2 , in a telephonic ... The Care Manager, Telephonic Behavioral Health 2 work assignments are varied ... The Care Manager, Telephonic Behavioral..
... guidance and pricing recommendations, gathering information, and consulting with customers and ... understanding of state-specific requirements and Health Insurance Portability and Accountability Act ... risks. Understanding of risk pool..
... get the right care and information based on their specific condition ... condition(s): Have a specific chronic health condition Are eligible for both ... care facility The Supervisor, Care..
... submits recommendations for appropriate change management. Applies clinical and coding experience ... of clinical experience within Home Health field Previous experience in medical ... or extensive experience in Home..
... The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term ... contracted working relationship with the health plan. The Senior Provider Engagement, ... The Senior Provider Engagement, Clinical..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support ... benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are..
Description The Senior Health Information Management Professional ensures data integrity for claims ... for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex ... variable factors...
Description The WEEKEND Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests ... as needed. The Pre-Authorization Behavioral Health Professional 2 work assignments are varied ... state As a Pre-Authorization..
Description The Payment Integrity Professional 2 uses technology and data ... financial recovery. The Payment Integrity Professional 2 work assignments are varied ... with Humana. The Payment Integrity Professional 2/Outpatient..
... The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, ... The Care Manager, Telephonic Behavioral Health 2 work assignments are varied ... a Care Manager, Telephonic Behavioral..
Description The Director of Product Management for Clinical Pharmacy Products develops ... As the Director of Product Management for Clinical Pharmacy Products, you ... Humana's Pharmacy-based product strategies, product management..
... on medical background and reviews health claims. The Medical Director work ... leading teams focusing on quality management, utilization management, discharge planning and/or home health or rehab Must be..
Description Humana's Claims Cost Management (CCM) organization is seeking a ... Required Qualifications Bachelor's Degree in health or business related field or ... protect member PHI / HIPAA information Preferred..
... member's physical, environmental and psycho-social health issues. Identifies and resolves barriers ... Care Managers, because our case management services are centered on the ... in achieving and maintaining optimum..
... the emotional, social, vocational, educational, health-related, developmental, and organizational concerns that ... and knowledge of general mental health, risk assessment and substance misuse ... Grief counseling, workplace problems, and..
... the Associate Director, IT Project Management, you will use your background ... background and experience in program management to lead and manage a ... The Associate Director, IT Project..
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..
