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... 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..
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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..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... or data requires an in-depth evaluation of variable factors. Responsibilities The ... Medicaid Quality Data and Reporting..
... or data requires an in-depth evaluation of variable factors. Responsibilities Assignment: ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting ... in the..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
... description, work plan, and annual evaluation. The Director, Quality Improvement requires ... ODM required measure reporting and evaluation. Ensure compliance with quality of ... and the Annual Quality Program..
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 Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for claims reserve valuation, financial forecasting, and strategic and operational decisions within ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
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, work plan, and annual evaluation. The Associate Director, Quality Improvement ... ODM required measure reporting and evaluation. Ensure compliance with quality of ... and the Annual Quality Program..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
Description The Staff Clinical Pharmacist- Clinical Formulary Administration monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge ..
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 ..
Description The Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
