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Description The Senior Stars Improvement, Clinical Professional is responsible for ... Stars program. The Senior Stars Improvement, Clinical Professional work assignments involve ... factors Responsibilities The Senior Stars Improvement, Clinical..
Description The Director, Process Improvement analyzes, and measures the effectiveness ... process improvements. The Director, Process Improvement requires an in-depth understanding of ... segment. Responsibilities The Director, Process Improvement researches..
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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..
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 ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Green Bay Wisconsin Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
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 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 ..
... 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..
Job ID 21000HSBAvailable 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. ..
... 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 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 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 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 ..
Job ID 21000EZYAvailable Openings 3 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of ..
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 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 ..
u003cpu003eu003cstrongu003eRole Summaryu003c/strongu003eu003c/pu003enu003cpu003eResponsible for agency sales and retention of senior product lines, as well as providing support to Agency Manager and sales team to achieve goals.u003c/pu003enu003cpu003eu003cstrongu003eIn this role you will:u003c/strongu003eu003c/pu003enu003culu003enu003cliu003eMaintain regular contact ..
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 ..
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 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 ..
... 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..
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u003c/strongu003eu003c/pu003enu003cpu003eThe Clinical Supervisor (RN) will oversee a team of 20 to 30 remote Medical Review Nurseu0026nbsp; Analysts (NA) that complete Targeted Probe and Educate (TPE) work for our Medicare ..
Senior Data Analyst at Healthgrades Madison, Wisconsin Healthgrades is focused on providing trusted information that helps consumers and providers make meaningful connections. As a Sr. Data Analyst , you will support ..
