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Description The Quality Assurance Technician develops and implements ... programs to establish and maintain quality standards of existing products and ... to focus employees on the quality of care given..
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 ..
Description The Care Manager, Telephonic Behavioral Health 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 ..
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 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 ..
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, ..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
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 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. ..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... a personalized, seamless and easy..
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 ..
... so that our members receive quality healthcare at an affordable price. You ... (RN) license 3 years of healthcare experience within a fraud investigations ... well as solid knowledge..
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 Care Management Support Assistant 3 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
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 ..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, ..
Description The Vendor Quality Medical Director will manage clinical ... Director will manage clinical vendor quality outcomes for Humana Clinical Operations ... Director to manage clinical vendor quality outcomes for..
... most to consumers, our clinical quality and brand strategy can help ... Strategy Advancement Advisor will support quality clinical strategy for Humana's Enterprise ... opportunities related to the clinical..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
