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Description The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires an in-depth ..
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... processing operations and systems. The Director, Claims Oversight plays a vital ... relate to claims. Responsibilities The Director, Claims Quality Audit will oversee ... exceptional results to the TRICARE..
... will report directly to the Director of Value-Based Strategies - CMS ... Bachelor's Degree 5 years in healthcare management, consultation, or similar role ... in Business, Public Health, or..
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 Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director, Utilization Management Nursing requires a ... clinical delivery process. The Associate Director, Utilization Management..
Description The Associate Director, Quality Assurance for Humana/Your Home ... Home Wellness Assessments. The Associate Director, Quality Assurance requires a solid ... care delivery. Responsibilities The Associate Director, Quality Assurance..
Description As the Associate Director, IT Project Management, you will ... your background and experience in program management to lead and manage ... our Medicare segment. The Associate Director is..
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 Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..
Inspired Living Tampa Tampa, Brandon, Riverview, Temple Terrace, Pinellas Help create an atmosphere of compassion, optimism, warmth, resident interest and positive emphasis, as well as a calm environment throughout the Community ..
Description The Director, Provider Reimbursement is responsible for ... team of associates. Responsibilities The Director, Provider Reimbursement develops and executes ... collaboration with other leaders, this Director will develop and..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..
Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Tampa Florida ... Tampa Florida Description The Associate Director, Compliance Nursing reviews utilization management ... waste, and abuse. The Associate Director,..
Description The Director, Strategy Advancement provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at ..
... Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving ... to supplement Humana's Health Assessment Program. The summary of the IHWA ... for necessary follow-up care. This..
Description The Director, Process Improvement analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Director, Process Improvement requires an in-depth understanding ..
Description Responsibilities The Associate Director for ACD Audit , at ... ACD Audit , at the director of the Director of Payment Integrity, will create ... optimizing operational processes. The..
Job Information Humana Associate Director Utilization Management in Tampa Florida ... are looking for an Associate Director, Utilization Management to utilize clinical ... benefit administration determinations. The Associate Director, Utilization..
Description The Director of Health Services for National ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... the clinical delivery process. The Director of Health Services..
Description The Director, Health Services utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health Services requires an in-depth understanding ..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
Description As the Director, Sales Product -Employer Group you will be responsible for defining and executing upon the sales product strategy & enablement plans across specific local markets and lines of ..
