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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
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 ..
... the prioritization of the health outcomes and care experiences of our ... critical in driving health related outcomes and transforming Humana's health first ... or Advanced Degree in Business,..
Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..
... industry insights to improve member outcomes Responsible for the identification of ... of initiatives that will improve outcomes Ability to leverage industry research ... a matrixed environment to deliver..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
Description The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high ..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
... drive improved customer experience and outcomes based on external inputs (e.g. ... deliver clinical, experiential and financial outcomes. Build and manage a high-performing ... reporting on product and client-level..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
Job Information Humana Social Worker-MSW and licensure required- Telephonic Behavioral Health-SNP- WAH Nationwide in Honolulu Hawaii Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and ..
... acumen to solve for the healthcare challenges of today. The Clinical ... clinical opportunities to improve health outcomes and improve the value of ... industry insights to improve member..
Job Information Humana Social Worker - Telephonic Behavioral Health-SNP- WAH Nationwide in Honolulu Hawaii Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' ..
Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Honolulu Hawaii Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Job Information Humana Telephonic Care Coach -WAH Nationwide in Honolulu Hawaii Description The Care Coach 1, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain ..
