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Description Be a part of the eBusiness team, drivers of provider self-service adoption through education and promotion of electronic transactions the Availity secure provider portal, Watson Voice, EDI, etc. As a ..
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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
... all areas impacting DCE operations, performance, experience, and outcomes including provider ... as they relate to provider performance, beneficiary experience, DCE growth, provider ... engagement strategy, identifying and implementing..
Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
... will create and implement process improvement plans focused on the beneficiary ... policy changes. Develop and monitor performance and quality of initiatives, providing ... reflection of full ACD team..
Description Humana is a $77 billion (Fortune 41) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... Government. Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will..
... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary. The PDC Care Manager will assist beneficiaries as they ... Military TRICARE - PDC Care..
Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Birmingham Alabama Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Description The Director, Process Improvement analyzes, and measures the effectiveness ... process improvements. The Director, Process Improvement requires an in-depth understanding of ... segment. Responsibilities The Director, Process Improvement researches..
... Autism Care Demonstration (ACD) team performance to ensure compliance with contract ... by ACD associates to assure performance compliance. Advises leadership to develop ... KEY ACCOUNTABILITIES 30 % Ensures..
... for a Lead Cloud Product Manager to join our Enterprise Architecture ... Architecture team. The Lead Product Manager Conceives of, develops, delivers, and ... Responsibilities The Lead Cloud Product..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
... (ASN), Utilization Management professional or Manager for clinical interpretations or determining ... and utilization management to maintain performance standards at all times. Assist ... times. Assist leadership in process..
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 ..
... practice of Quality Assessment and Improvement (QAI), including use of FMS ... coaching and counseling employees, including performance reviews, disciplinary action and terminations. ... Leader responsibilities Responsible for overseeing..
... (CCM) organization is seeking a Manager, Fraud & Waste to join ... As the Fraud & Waste Manager at Humana, you will support ... recommendations Identify and suggest process..
Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
Description Your Home Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving clinical and quality outcomes by bridging the gap between the physician's office and the member's home. YHA ..
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... you succeed, we succeed! The Manager, Care Management oversees..
