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... Translates FM objectives into individual performance goals for direct reports and ... direct reports and helps define performance goals. Develops an annual development ... succession plan. Drives and tracks..
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Description The Senior Stars Clinical Professional (RN) works through phone calls and other outreach methods with members, providers, and/or vendors to close HEDIS care gaps. The Senior Stars Clinical Professional work ..
Description The Senior Stars Improvement, Clinical Professional responsible for the ... Stars Program. The Senior Stars Improvement, Clinical Professional work assignments involve ... factors. Responsibilities The Senior Stars Improvement, Clinical..
Description The Senior Process Improvement Professional analyzes, and measures the ... process improvements. The Senior Process Improvement Professional work assignments involve moderately ... well as other HCS Business Improvement, Technology,..
Description The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments ..
Description The Pre-Authorization Behavioral Health Professional 2 reviews prior authorization requests for appropriate care and setting, follows guidelines and policies, and approves services or forwards requests as needed. The Pre-Authorization Behavioral ..
Description As Lead Actuary of the Risk Predictive Models team, you have an opportunity to both learn more about predictive analytics and machine learning and to see it become very real ..
... that our members receive quality healthcare at an affordable price. You ... recommendations Identify and suggest process improvement opportunities Develop and monitor team ... and coaching, and conduct annual..
u003cpu003eu003cstrongu003eThis job exists to:u003c/strongu003e The purpose of this position is to maximize patient services revenue, in accordance with applicable federal and state laws, regulations, etc., and to provide effective leadership and ..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Ensure adherence to policies and performance standards in accordance with the ... participate in Care Management quality..
Registered Nurse (OB) - Obstetrics We are pleased that you are exploring employment opportunities with Arkansas Valley Regional Medical Center (AVRMC). AVRMC is located in La Junta, Colorado, just west of ..
... concurrent reviews to identify documentation improvement opportunities according to CMS and ... for diagnosis code selection Educate healthcare provider, coder and/or office staff ... long-term, self-sustaining solution for the..
Description Responsibilities This position will maintain the Humana Military ACD website Autism Center of Excellence (CoE); ensuring educational information is current and relevant to training needs in addition to analyzing and ..
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 ..
... the ability look at provider performance metrics and be able identify ... available resources Performs analysis of performance indicators and puts together a ... with providers to participate in..
u003cpu003eu003cstrongu003eThis job exists to:u003c/strongu003e Serve as coach and leader for the clinic, to problem solve and trouble-shoot operational issues at the site and provide support so the pods run effectively and ..
Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
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 ..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..