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Description The Clinical Strategy & Practice Lead will oversee our behavioral health (BH) clinical program for Oklahoma's Medicaid plan enrollees. They will collaborate closely with the Health Services Director and RVP, ..
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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 Provider Contracting Executive works on problems ..
... (5) years of experience in healthcare or risk management. Minimum three (3) years ... (2) years of experience in healthcare investigations and/or risk management. Must be located in .....
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 ..
... 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 Associate Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Associate Director, Provider Contracting requires ..
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 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 Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..
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 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 Tulsa Oklahoma Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and ..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..
... 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..
Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
Job Information Humana (RN)Associate Director, Care Management - Oklahoma City, OK in Tulsa Oklahoma Description The Associate Director, Care Management leads teams of nurses and behavior health professionals responsible for care ..
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 Manager, Utilization Management (Behavioral Health) utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management ..
