Healthcare Improvement Specialist Jobs in Portland

Actuarial Analyst II,III - Any Anthem Office location or Remote in United States - PS11071 New Location: United States Field: Actuarial Requisition #: PS11071 Post Date: 4 days ago Your Talent. ..

Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..

Job Information Humana Actuary, Risk and Compliance in Portland Maine Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..

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

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 ..

Description The Site Reliability Engineering (SRE) Lead Technology Leadership Professional - Pharmacy Dispensing Solutions is responsible for all aspects of the production environment support strategy, Operational Excellence strategy and execution, and ..

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 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 ..

LICENSED CLINICAL SOCIAL WORKER - LCSW Job Locations US-ME-BIDDEFORD | US-ME-PORTLAND | US-ME-LEWISTON ID 2022-58500 Position Type PRN Line of Business Rehab Without Walls NeuroSolutions Our Company Rehab Without Walls NeuroSolutions ..

... in Portland Maine Description Responsibilities Healthcare isn't just about health anymore. ... of our members, and the healthcare industry as a whole. Assignment ... enhance data analytics and operational..

Job Information Humana Vendor Management Specialist 3 in Portland Maine Description ... Maine Description The Vendor Management Specialist 3 works as liaison between ... and organization. The Vendor Management Specialist..

... internal stakeholders in support of Healthcare Interoperability and compliance to CMS ... criteria for the measurement of Healthcare Interoperability and compliance to CMS ... areas with issue resolution 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 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 Healthcare isn't just about health anymore. ... of our members, and the healthcare industry as a whole. Responsibilities ... excellence, consistent process monitoring and improvement. Effectively influence the multiple..

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 ..

... We are the future of healthcare and our mission is to ... will help members through their healthcare journey, ensuring they get the ... are: Passionate about transforming our..

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 ..

... internal stakeholders in support of Healthcare Interoperability and compliance to CMS ... criteria for the measurement of Healthcare Interoperability and compliance to CMS ... areas with issue resolution and..

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, ..

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 Technology Leadership Professional is responsible for all aspects of software or hardware product delivery and performance. The Lead Technology Leadership Professional works on problems of diverse scope and ..

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