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... standards; Participate in all quality improvement procedures and adhere to quality ... procedures and adhere to quality improvement standards; Abide by the policies ... Knowledge of the utilization review..
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 ..
... Humana is a Fortune 60 healthcare company with a history of ... 50 years as a proven leader and innovator in the health ... top place to work in..
Description The Associate Director, Consumer Engagement oversees the enrollment, education, engagement, and activation duties for client groups regardless of segment, and for product where warranted. The Associate Director, Consumer Engagement requires ..
Description The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 work assignments are varied and frequently ..
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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 ..
... to support risk identification, analysis, process design and implementing control practices ... 1-2 years operational experience in healthcare/managed care Ability to manage enterprise ... assessing risks, design and implementation..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
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 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 ... and recommendations Identify and suggest process improvement opportunities Develop and monitor team ... (RN) license 3 years..
Job Information Humana Medicaid Associate Director, Compliance Nursing in San Juan Puerto Rico Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, ..
