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Bristol-Myers Squibb is a global Biopharma company committed to a single mission: to discover, develop, and deliver innovative medicines focused on helping millions of patients around the world in disease areas ..
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CPHRM College Degree required 5 years clinical hospital experience as a registered nurse Ability to organize and manage; Knowledge of the principles and practices of risk management. Knowledge of the operations ..
Description The Director, Health Services utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health Services requires an in-depth understanding ..
Job ID 21000EQKAvailable Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Job ID 21000F3OAvailable Openings 2 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
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 ..
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 ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Lancaster South Carolina Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
Description The Transplant Care Manager, Telephonic Nurse 2 , in ... of members. The Transplant Care Manager, Telephonic Nurse 2 work assignments ... home anywhere The Transplant Care Manager, Telephonic..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Government. Responsibilities The Telephonic..
... Humana is a Fortune 60 healthcare company with a history of ... developing a robust integrated care delivery model that integrates insurance with ... top place to work in..
... care, and/or requested site of service should be authorized. All work ... inpatient, post-acute care environments, outpatient service requests, ER review, pharmacy review ... whether services provided by other..
Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... schedules and goals. Responsibilities The Manager, Utilization Management Nursing..
... training programs to support the delivery of quality patient care as ... PCT’s. Collaborates with the Clinical Manager and Education Coordinator in driving ... directed. Monitors processes in the..
Description Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will assess, plan, coordinate, implement, ... Care Management Team, the care manager..
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 ..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary...
Description The Senior Product Manager - Fully Insured supports strategy ... Fully Insured supports strategy development, delivery, and management of the 100 ... business. Responsibilities The Senior Product Manager supports..
