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Description The Account Management Financial Analyst analyzes and forecasts financial, economic, ... forecasts financial, economic, and other data to provide accurate and timely ... and operational decisions. This Financial Analyst..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Birmingham Alabama Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese and ..
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Description The Financial (Pricing) Analyst analyzes and forecasts financial, economic, ... forecasts financial, economic, and other data to provide accurate and timely ... and operational decisions. This Financial Analyst work..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Description The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... system tools and database or data warehouse queries and scripts. In ... the analysis of..
... is currently seeking an experienced Healthcare Consultant to join our team. ... Preferred Credentials and Experience A Healthcare Consultant is a dynamic, high ... business and medicinal components of..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships ... goals. The Senior Value-Based Programs Analyst works on problems of diverse ... Responsibilities The Senior Value-Based Programs Analyst..
Job ID 21000J5VAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Clinical Data and Reporting Professional 2 generates ... leadership decision making. The Clinical Data and Reporting Professional 2 also ... Reporting Professional 2 also pulls data out of..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
... leverages its advanced knowledge of data, modeling, optimization, and tools. Applies ... operates. Understands and analyzes complex data, articulates to various units within ... 2 - 5 years of..
Job ID 21000G0RAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
... for a Senior Business Systems Analyst to join working remote anywhere ... US! The Senior Business Systems Analyst performs analysis of business, process ... specifications. The Senior Business Systems..
... working with key partners and data analyst(s). Required Qualifications Bachelor's degree or ... to 5 years of technical healthcare experience Exceptional oral and written ... Proven ability to perform..
