Healthcare Quality Analyst Jobs

Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..

Job Information Bristol Myers Squibb Senior Global Feasibility Lead in Jersey City New Jersey Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver ..

Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..

Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the ..

At Bristol Myers Squibb, we are inspired by a single vision - transforming patients' lives through science.In oncology, hematology, immunology and cardiovascular disease - and one of the most diverse and ..

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 ..

... Member Plan (EFMP), auditing for quality and clinical compliance, and case ... compliance with ACD. Monitor for quality standards, claims accuracy, fraud, and ... Qualifications BCBA (Board Certified Behavior..

Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..

Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..

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 The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Jersey City New Jersey Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, ..

... the development and implementation of quality improvement interventions and audits and ... years of experience in Accreditation, Quality Management, Compliance, Utilization Management, Behavioral ... degree Advanced degree in a..

Description Humana is seeking a Director of Strategy with significant strategy consulting experience to manage and deliver strategy projects and analysis on behalf of our Medicare Prescription Drug Plan business. You'll ..

Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..

Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..

Description The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... factors. Responsibilities The Senior Medicaid Quality Data and Reporting Analyst will be responsible for the..

Description The Principal Quality Leader will lead testing and ... Leader will lead testing and quality collaboration between Business and IT, ... tools and assure adherence to quality standards. Serves..

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 Come join the Digital Health & Analytics (DH&A) team within Humana to build a world class Data Science and Insights enterprise capability leveraging digital-first platforms, analytics, and agile development methodologies. ..

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 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 ..

... activities h. Ensure the utmost quality of risk management submission content ... management skills to ensure high quality deliverables are provided in a ... U.S. REMS departments (Customer Care,..