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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..
... member's physical, environmental and psychosocial health issues. Identifies and resolves barriers ... member's physical, environmental and psychosocial health issues. Identifies and resolves barriers ... limitation or assistance. See Additional..
Description The Manager, Care Management leads teams of nurses and ... teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines..
Job Information Humana Medicaid Associate Director, Compliance ... Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... multiple managers or highly specialized professional associates. The Associate Director,..
... 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..
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..
... 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..
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..
Job Information Humana Market Leadership Advisor (Managed/Health Care Industry) San Juan, PR ... operations, and results of a health plan. The Market Leadership Advisor ... their respective functions. Represents the..
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..
... 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..
... 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..
... to meet an individual's comprehensive health needs through communication and available ... MTF CMs. Perform telephonic care management with beneficiaries throughout the East ... support groups Participate in care..
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..
... 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..
... monitoring and evaluating the case management plan against the member's personal ... relevant experience Six years of professional human services experience. Previous experience ... or long term care case..
... 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 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..
