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... to build a world class Data Science and Insights enterprise capability ... Through the strategic interpretation of data, we provide our consumers-physicians, patients, ... and analyzing diverse types of..
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Description The Senior Quality Assurance, Clinical Professional requires being ... high accountability of compliance and quality and will work assignments involving ... the analysis of situations or data requires an..
... the analysis of situations or data requires an in-depth evaluation of ... as well Medical Review, Market Quality Operations, and other processes found ... Develop and implement cost per,..
... leverages its advanced knowledge of data, modeling, optimization, and tools. Applies ... that improve the outcomes and quality of the programs we offer. ... operates. Understands and analyzes complex..
... Develop and monitor performance and quality of initiatives, providing insight and ... and output of clean, useable data for further analysis, ensuring CDRL ... needs, process flow, system needs,..
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 ..
... through the collection of market data and internal analysis, with a ... infrastructure. Contribute to creation of top-quality presentations for senior leadership on ... and make recommendations from complex..
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 ..
... relationships with physicians, providers and healthcare systems in order to support ... support and improve financial and quality performance within the contracted working ... the analysis of situations or..
... acumen to solve for the healthcare challenges of today. The Clinical ... team uses advanced scientific techniques, data analysis, forecasting, and clinical acumen ... their skills to assist with..
Description The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high ..
Description The Problem, Incident and Event Management Engineer 2 monitors trends in incidents and system issues and helps drive technical support teams to recover services during periods of service disruption or ..
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 The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... system tools and database or data warehouse queries and scripts. In ... the analysis of..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... The Strategy Advancement Advisor provides data-based strategic direction to identify and ... (ECM) team needs your business, healthcare and research acumen to solve ... acumen to solve for the..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Torrance California Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
... acumen to solve for the healthcare challenges of today. The Clinical ... team uses advanced scientific techniques, data analysis, forecasting, and clinical acumen ... various analytical organizations to lead..
... The Director, Strategy Advancement provides data-based strategic direction identifying and delivering ... set on transforming the US healthcare system and making real improvements ... Medicare and Medicaid), by leveraging..
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 ..
... and available resources to promote quality, cost-effective outcomes. Coordinate medical, behavioral ... ACD policy, provide outcome measure data to respective providers; serve as ... ensure care coordination assistance. Ensure..
