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... care system and prior community leadership experience within health-related foundations, associations, ... will possess broad managed care leadership experience and significant Medicare Advantage ... Establish and maintain an executive..
... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... approach to providing strategic thought leadership to identify and address complex ... Claims, Grievance and Appeals, Market..
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 ..
... 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an accomplished healthcare leader for the newly-created role ... quality, appropriate, and cost-effective behavioral..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
DescriptionInspire and inform each patient. Allow others to achieve their most important objectives while you achieve yours. Improve their prospects-and the vitality of your career. Connect with your goals and change ..
Job Information Humana Healthcare Services Senior Learning Design Professional-Remote in Honolulu Hawaii Description The Senior Learning Design Professional uses instructional design, cognitive psychology and adult learning theory to determine the appropriate ..
Job Description Founded in 1921, Straub Medical Center includes a 159-bed hospital in Honolulu, a network of neighborhood clinics and a visiting specialist program that reaches throughout the state of Hawai'i. ..
Job Description & RequirementsSocial Worker - Acute - (SW - Acute)StartDate: 03/14/2022Available Shifts: 8 D, 10 D Pay Rate: $1450.00 - 1900.00Must have a Master's Degree in Social Work, and current ..
... for one of the leading healthcare organizations. Reporting to Director of ... by delivering personalized, simplified, whole-person healthcare experiences. The Associate Director, Full ... forecasts (labor and non-labor). Provide..
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 Technical Product Manager - Remote in Honolulu Hawaii Description The Senior Product Management Professional/Technical Product Manager (TPM) must be able to lead, plan and track all phases of ..
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 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 ..
... communicate across all levels of leadership within Humana and be able ... management experience and/or clinical implementation Leadership skills Advanced knowledge of Microsoft ... Management experience Specialty Pharmacy experience..
Description The Manager, Medical Coding oversees the coding team that is reviewing inpatient records for appropriate coding to include ICD-10, CPT, and HCPCS. The Manager, Medical Coding works within specific guidelines ..
Description Humana Medicaid is growing and you have the unique opportunity to grow with us! Join our team and propel Humana forward to solve the technology challenges of tomorrow. You'll collaborate ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
