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... administration of care management. Provides non-clinical support to the assessment and ... increase access to services; conduct non-clinical outreach to assist families with ... questions. Identifying available local resources..
... The Nurse Auditor 2 performs clinical audit/validation processes to ensure that ... you love auditing and investigating clinical/coding information, researching medical materials and ... opportunity. Performs in a production..
... with Actuary, MRA, Corporate Finance, Clinical and Market Point internally and ... Tableau and/or PowerBI dashboards Excel based reporting tool building with some ... be EST hours. Work at..
... closely with our local market Clinical, Provider Engagement, MRA (Medicare Risk ... who work outside of their home to submit proof of vaccination, ... in the field. Work at..
... May create specifications for reports based on business requests. Begins to ... and effective working relationships with Home Ops leadership and other departments ... metrics to support and improve..
... Actuary, MRA, Corporate Finance and Clinical departments to drive optimization inclusive ... who work outside of their home to submit proof of vaccination, ... in the field. Work at..
Description The RN Clinical team is looking for a ... will be someone who applies clinical and coding experience in their ... that match the query. Applies clinical and coding..
... or enrollment2. Provider data management3. Clinical care or utilization management (UM)4. ... management (UM)4. HEDIS Quality measurements5. Value-based care6. Regulatory and compliance7. Claims ... Deep understanding of insurance and..
... a comprehensive analytic review of clinical documentation to determine if an ... at the comfort of your home due to previous experience/breadth and ... with the ability to interpret,..
... of Trend Analytics. As a clinical trend leader you will support ... enterprise trend governance providing critical clinical and strategy assessment. Through working ... trend transformation, retail business, enterprise..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to ... healthcare challenges of today. The Clinical Analytics and Trend team uses ... techniques, data analysis,..
... operations - to embrace modern cloud-based technologies and engineering, agile ways ... basis to attend in-person meetings based on business need. Responsibilities: As ... customer and user feedback and..
... to telecommute * (work from home) as you take on some ... be conducted virtually from your home. *All Telecommuters will be required ... Groups Telecommuter Policy. Primary Responsibilities:..
... improve cost and evaluate value based arrangements. KEY ACCOUNTABILITIES Elevate Health ... equivalent experience Johns Hopkins Adjusted Clinical Group software certification Demonstrated expertise ... coordination procedures Knowledge of community..
Job Information Humana Value-Based Strategies - CMS Programs Strategy ... Remote in Honolulu Hawaii Description Value-Based Strategies - CMS Programs Strategy ... combination of big-picture vision, deep value-based care experience..
... traditional silos and design solutions based on how our members seek ... several impacted business areas, including clinical services, sales, marketing, IT/technology, and ... experiences to members that improve..
... The Enterprise Transformation Lead provides data-based strategic direction to identify and ... necessary; support dialysis in the home setting. The Enterprise Transformation Lead ... and produce recommendations and plans..
... in Honolulu Hawaii Description Humana's Clinical Trend and Analytics team is ... Scientist. This position can be work-at-home from anywhere, as long as ... work some EST hours. The..
Job Information Humana Associate VP, Research Consulting-Humana Healthcare Research (HHR). in Honolulu Hawaii Description ... to identify and execute on research topics relevant to the business ... mentorship of other..
... leadership and oversight of the research of quality/outcome measure development and ... including developing the technical and research plans for measure development, identifying ... measures, and conceptualizing and supervising..
... care management. The CMSS provides non-clinical support to the assessment and ... assignments. CMSS's work collaboratively with clinical support associates, (including nurses and ... include weekend hours. In this..
... Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... be licensesd in multiple states..
