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Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
... 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 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 ..
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... Develop and monitor performance and quality of initiatives, providing insight and ... changes, be responsible for overarching project planning and deliverables for the ... lead development of meaningful QIPs..
... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the Healthcare Clinical Operations. After completion of ... Participates in corporate-wide committees Performs..
Description The Medical Coding Auditor Supervisor handles a combination of tasks, including extracting clinical information from a variety of medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, ..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
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 ..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
... acumen to solve for the healthcare challenges of today. The Clinical ... low value care and related healthcare resource waste, with a focus ... news and reports in the..
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 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..
... acumen to solve for the healthcare challenges of today. The Clinical ... anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... progress and performance against the..
