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... support of the market's quality improvement (QI) strategy and execution. Responsibilities ... expertise within the realm of Healthcare Quality operations and improvement methodology, HEDIS/CAHPS and other forms ... of..
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Description Responsibilities This position will maintain the Humana Military ACD website Autism Center of Excellence (CoE); ensuring educational information is current and relevant to training needs in addition to analyzing and ..
Description The Senior Stars Improvement, Clinical Professional responsible for the ... Stars Program. The Senior Stars Improvement, Clinical Professional work assignments involve ... factors. Responsibilities The Senior Stars Improvement, Clinical..
Description The Experience Strategy & Transformation Lead enhances the consumer experience by architecting experiences and building capabilities that will positively impact our customers. The Experience Strategy & Transformation Lead works on ..
Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The Pharmacy ..
Job ID 21000HL6Available 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 Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization Behavioral ..
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 ..
... that our members receive quality healthcare at an affordable price. You ... recommendations Identify and suggest process improvement opportunities Develop and monitor team ... (RN) license 3 years of..
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 As Lead Actuary of the Risk Predictive Models team, you have an opportunity to both learn more about predictive analytics and machine learning and to see it become very real ..
... development and implementation of quality improvement interventions and audits and assists ... priorities Commitment to continuous process improvement Exceptional verbal and written communication ... degree Advanced degree in a..
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 ..
Job ID 21000HLPAvailable 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 Humana has articulated a long-term vision to transform from a health insurance company to a health services company distinguished by the prioritization of the health outcomes and care experiences of ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
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 ..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
Job Information Humana Actuary, Risk and Compliance in Meridian Idaho Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..
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 ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Meridian Idaho Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the ..
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 ..
