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... exceptional results to the TRICARE Program. In this role you will: ... requirements related to the TRICARE Program related to claims processing. Ensure ... support compliance with the TRICARE..
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..
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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 ..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
... compliance, and quality performance and staffing management. Detailed Responsibilities include: Leads ... Support development of national clinical staffing models and work with Medicaid ... with Medicaid markets to support..
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 Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
... Humana Clinical Analytics and Trend Program Manager in Pittsburgh Pennsylvania Description The ... The Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... managers across the..
Description The Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... to administer the TRICARE health program for military members, retirees and ... through TRICARE and other military healthcare programs...
... for Change Orders, for ACD Program Integrity Audit; driving to operational ... team to work with ACD Program Integrity leadership, develop new, or ... leadership, develop new, or change..
... your background and experience in program management to lead and manage ... of the segment PMO, ensuring staffing is appropriate to meet program and project needs, mitigating overall .....
... acumen to solve for the healthcare challenges of today. The Clinical ... home anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... team Low Value Care..
... to administer the TRICARE health program for military members, retirees and ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Discharge Call (PDC) Telephonic Care..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
