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Job Information Humana Medicaid Associate Director, Compliance Nursing in Troy Michigan Description The ... Troy Michigan Description The Associate Director, Compliance Nursing reviews utilization management activities and ... waste, and..
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Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, ... benefit administration determinations. The Associate Director, Utilization Management Nursing requires a solid understanding of..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description This position is for Enclara Pharmacia, a Humana company. Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the nation's largest ..
Description Job Summary The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The ..
Job Information Humana Associate Vice President, Quality Improvement for Healthy Horizons in Troy Michigan Description As a company whose primary focus is on the well-being of its members, Humana is dedicated ..
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 ..
Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
... operations. You will develop the nursing and clinical department goals, objectives, ... and implementing the Standards of Nursing Practice and the clinical operations ... of experience at a senior..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Troy Michigan Description The ... Troy Michigan Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support..
Job Information Humana Director, Behavioral Health Strategy in Troy Michigan Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care for ..
Description Responsibilities The Director, Health Services uses clinical knowledge, communication and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the flexibility ..
Job Information Humana Nationwide Medicaid Behavioral Health Quality Lead in Troy Michigan Description The Behavioral Health Quality Lead will report directly to the National Medicaid Quality Director, and be responsible for ..
Description The Chief Medical Officer, Group Medicare relies on the medical background to create and oversee clinical strategy for the Group Medicare business. The CMO Group Medicare, requires and in-depth understanding ..
Job Information Humana RN Telephonic Transplant Care Manager-WAH in Troy Michigan Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to ..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
