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... and actively participates in process improvement activities that enhance the likelihood ... competency evaluations/audits to ensure ongoing performance of other PCT’s. Collaborates with ... the practice of Continuous Quality..
... Medical Director. Regularly reviews integration performance, network adequacy, performance improvement projects, and surveys related to ... Shall work closely with the Performance/Quality Improvement Coordinator, Behavioral Health Network Director, .....
... content expert in value-based contracting, performance improvement, HEDIS and quality improvement. This individual represents Humana Healthy ... associate development, and monitors team performance against key performance indicators or contractual..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Claims Research & Resolution (Claims Administrator) who will be responsible for the administration of a comprehensive claims processing system capable of ..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management (Behavioral Health) who will utilize clinical skills to support the coordination, documentation, and communication of behavioral health services and/or ..
Description Humana Healthy Horizons in Louisiana is seeking a RN, Clinical Educator (Nursing Educator 2) who will plan, direct, coordinate, evaluate, develop, and/or deliver trainings and education programs for professional nursing, ..
Description Humana Healthy Horizons in Louisiana is seeking a Manager, Utilization Management Nursing who will utilize clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit ..
... is seeking a Manager, Quality Improvement who will implement and monitor ... will implement and monitor quality improvement program components, including annual program ... annual evaluation. The Manager, Quality..
Description The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for ..
Description The Medicaid Housing Specialist (Care Management Support Professional 1)contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or ..
Description Humana Healthy Horizons in Louisiana is seeking a RN, Manager of Care Management to lead our Maternal-Child health care management operations and staff for the Moms First program, to ensure ..
