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Description The Problem, Incident and Event Management Engineer 2 monitors trends in incidents and system issues and helps drive technical support teams to recover services during periods of service disruption or ..
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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 Senior Clinical Business Professional manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Senior Clinical Business Professional ..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
... ACD policy, provide outcome measure data to respective providers; serve as ... ensure care coordination assistance. Ensure data is entered accurately and monitor ... any necessary corrections so that..
... Program Business Owners with metrics reporting and program performance including ROI ... improvements to current processes. Create reporting tools to track results, provide ... working with key partners and..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
... Health Information Management Professional ensures data integrity for claims errors. The ... the analysis of situations or data requires an in-depth evaluation of ... compliance standards via analysis of..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Honolulu Hawaii Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... acumen to solve for the healthcare challenges of today. The Clinical ... team uses advanced scientific techniques, data analysis, forecasting, and clinical acumen ... their skills to assist with..
Description The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high ..
Description The Senior Risk Management Professional a critical member within Humana's Third Party Risk Management Program (TPRM), a 2nd Line of Defense function, will be responsible for maturing our program by ..
... forecasts financial, economic, and other data to provide accurate and timely ... operational decisions. Establishes metrics, provides data analyses, and works directly to ... Responsibilities The Actuary, Analytics/Forecasting ensures..
... to build a world class Data Science and Insights enterprise capability ... Through the strategic interpretation of data, we provide our consumers-physicians, patients, ... and analyzing diverse types of..
... using both internal and external data sources, and allowing us to ... at least 1 year of healthcare experience, or ASA with at ... at least 3 years of..
