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Description Responsibilities The Senior Business Systems Analysis Professional formulates and ... a good understanding of applicable business systems and industry requirements. Devises ... in place to meet needed business capabilities..
Description The Senior Application Architect designs and develops IT applications architecture solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments involve ..
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Job Information Humana Medicaid Associate Director, Compliance Nursing in Brentwood Tennessee Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Job Information Humana Sr. Clinical Recruiter - VSP( Variable Staffing Pool) in Brentwood Tennessee Description The Senior Recruiter interviews prospective employees for hourly and salaried positions. Assists with university graduate and ..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... report information for end-users using system tools and database or data ... Medicaid Quality Data and Reporting..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
Description The Clinical Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also pulls ..
... as a focus on collaborative business relationships, value based care, population ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
... and executing on Humana's consumer-focused business strategy demands constant negotiation with ... and documentation within a tracking system. May assist with identifying and ... to ensure effective and efficient..
... vendors, as needed. Humana Government Business government contract requires U.S. citizenship ... to support trend opportunities or business needs. Includes documenting and delivering ... of staffing needs, process flow,..
... criteria in the Formulary Enterprise System Evaluates new medications and accurately ... Collaborates with other pharmacists and healthcare professionals in a team environment ... Manages and communicates line of..
Description The Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..
... technological solutions to meet Medicaid business needs within a specified scope ... developing, guiding, and documenting clinical business system and functional processes, influences system design to optimize support and..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
Description The Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
... is look for a Senior Business Systems Analyst to join working remote anywhere ... in the US! The Senior Business Systems Analyst performs analysis of business, process and user..
