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... for timely decisions and reporting performance to include improvement plans when ... ABA queue call management and performance standards; Establish and maintain open ... beneficiary and provider experience, team..
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Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in San Antonio Texas Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese ..
Job Information Humana Healthcare Lead Product Manager: Hispanic Segment Medicare Advantage in San Antonio Texas Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Hispanic MA customer ..
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 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 Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Senior User Interface Design Engineer is generally focused on the look, feel, operation, user experience and functionality of a commercial website. Creates internal/external company web pages including graphics, animation ..
... Oversight will: monitor the clinical performance of the third party vendor ... oversight including quality, compliance and performance experience Experience in managed care ... field Previous experience managing program..
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 o Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical ..
Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships ... Responsibilities The Senior Value-Based Financial Analyst advises executives to develop functional ... Qualifications Bachelor's degree in Business, Healthcare,..
... for ensuring the investment and performance are consistent with customer needs. ... to provide Humana with product performance, reduced trend and growth. Serve ... insights Bachelor's degree in Business,..
Description In order to make lasting, positive impact and change in the healthy equity of the communities we serve, leveraging the support of key stakeholders will be critical. As healthy equity ..
... 60 market leader in integrated healthcare with a clearly defined purpose ... us redefine the future of healthcare. With a history of transformation ... about solving big problems in..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description The Senior HR Business Partner; Primary Care Organization leads the people management agenda in a business unit/area, and acts as a facilitator for the company's management team. Applies broad experience ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Supervisor, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Supervisor, Care Management works within thorough, prescribed guidelines and procedures; uses independent judgment ..
... and medication related Star measure performance. The Pharmacy Clinical Advisor Professional ... with metrics reporting and program performance including ROI analyses. Taking action ... with key partners and data..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... Medicaid Quality Data and Reporting Analyst will be responsible for the ... Qualifications: Bachelor's degree in Business,..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
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 ..
Description The Senior Database Administrator manages and maintains all production and non-production databases. Responsible for standards and design of physical data storage, maintenance, access and security administration. The Senior Database Administrator ..
