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Description The Enterprise Transformation Lead plans, performs and implements process improvement initiatives such as Lean or Six Sigma. The Enterprise Transformation Lead works on problems of diverse scope and complexity ranging ..
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... that happen. Responsibilities The Case Manager/Care Coach will work in clinic ... care. Job Functions: The Case Manager/Care Coach will work the following: ... vendors to ensure the member's..
Description The Senior Technical Product Management Professional Clinical Rules Engine leads a cross-functional technology project/product teams from design to delivery of developed clinical based software analytics and decision making solutions that ..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
Job Information Humana Manager, Behavioral Provider Contracting - Remote in San Antonio Texas Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers ..
Description Humana is looking for an experienced Counselor that truly enjoys helping those in need within a call center environment. Our Counselor's provide ongoing and crisis intervention counseling focused on the ..
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, ..
Description Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions. Consumers expect more personalized and holistic experiences from their health partners. Humana's Enterprise Clinical Operating ..
Job Information Humana RN Case Manager / Care Coach - San Antonio, TX in San Antonio Texas Description At Conviva Care Solutions, we want to inspire people to live life their ..
... Review customer data and assess risk, providing accurate case documentation and ... and sound decisions Evaluate financial risk in conformance with underwriting policies, ... rejects non-qualifying risks. Understanding of..
... 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..
... is seeking a Director of Risk Adjustment for the Texas/Louisiana area. ... of coders responsible for all risk adjustment functions to support Conviva's ... adjustment functions to support Conviva's..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
Description The Senior HR Business Partner; Primary Care Organization leads the people management agenda in a business unit/area, and acts as a facilitator for the company's management team. Applies broad experience ..
Description As the Associate Director, IT Project Management, you will use your background and experience in program management to lead and manage a team of PMO professionals that support the delivery ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
Description Healthcare isn't just about health anymore. ... of our patients, and the healthcare industry as a whole. The ... a whole. The Field Care Manager Nurse 2 will work..
... will take ownership of Medicare risk adjustment programs that fit best ... clinical best practices in the risk adjustment methodology, understanding clinical suspects ... role reports to the MRA..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Government. Responsibilities The Telephonic Care Manager will..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
