Healthcare Improvement Specialist Jobs in Cincinnati

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 RN Clinical team is looking for a dynamic Registered Nurse to join the team working remote anywhere in the US or in Louisville, KY! We are looking for someone ..

Description The Staff Clinical Pharmacist is an integral part of the Clinical Drug Policy Management team which ensures synchronization of formulary utilization management policies across multiple systems. Humana is seeking a ..

Job Information Humana FP&A Lead, Medicaid Market in Cincinnati Ohio Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..

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 ..

Job Information Humana Senior Quality Improvement Professional - EPSDT - Office ... Ohio Description The Senior Quality Improvement Professional-EPSDT (Early Periodic Screening Diagnosis ... Diagnosis and Treatment) uses quality improvement..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Job Information Humana Manager, Care Management in Cincinnati Ohio Description Responsibilities The Care Management Manager has responsibilities for the administration, clinical and operational management and compliance with Defense Health Agency policy, ..

Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Cincinnati Ohio Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..

Job Information Humana Provider Engagement Executive - Behavioral Health in Cincinnati Ohio Description The Behavioral Health Provider Engagement Executive utilizes their knowledge and skills to develop and grow positive, long-term relationships ..

Clinical Director  Sojourner Recovery Services JOIN OUR TEAM Develop a career dedicated to connection, compassion, and community. Join our dedicated team of professionals in fostering hope and transforming lives.  Community Health ..

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Cincinnati Ohio Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

New: Internal Medicine/Hospitalist Opportunities in Metro Cincinnati, Ohio!!rnrnBase Salary of $200K rnrnJob DescriptionrnrnOrganization is looking for dynamic individuals to join our team! It is a leading healthcare system specializing in providing ..

... Certified Diabetes Care and Education Specialist-Remote-US in Cincinnati Ohio Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..

OverviewRehab Program Manager - ALF SettingnnRehab Program Manager position available to begin ASAPnFlorence, Kentucky Assited Living settingnFull Time - 30-40 hrs/weeknFull Benefits package including Medical/Dental/Vision Insurance, 401K, CEUs, and PTOnMust be ..

Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..

Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..

Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..