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Constellis was established in 2010 by a group of operators and investors who sought to combine best-in-class brands, assets and people within the complex risk management industry. Today, the leading provider ..
... other managers across the department. Lead Risk Adjustment initiatives with engaged ... between Humana and provider groups Lead Practitioner Assessment Form program Collaborate ... market reviews and MAPD bid..
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Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
... plan design, implementation and assessment process as part of the Incentive ... working with the Design Compensation Lead to create and implement incentive ... reports for business leaders ...
Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Family Physicians Group (FPG) and Partners in ..
Description Humana's Claims Cost Management (CCM) organization is seeking a Manager, Fraud & Waste to join the Provider Payment Integrity-Clinical Audit team working remote anywhere in the US. As the Fraud ..
... to enhance the clinical delivery process. The Associate Director, Compliance Nursing ... problems within department(s), and could lead multiple managers or highly specialized ... Responsibilities include: Leads Medicaid operational..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of ... course of action. Responsibilities Responsibilities Lead a team of Pharmacy Professionals ... business Actively identifies and owns process improvements..
... Integrity, will create and implement process improvement plans focused on the beneficiary ... processes. The Associate Director will lead design and implementation of the ... design and implementation of..
... Responsibilities The ACD Program Integrity Lead responsibilities include analyzing data, reporting ... planning and implementation of across-the-board process improvement initiatives, including both tactical and ... provide in-depth analysis of..
... drug therapy optimization. Oversee and lead the specialty drug clinical program ... updates, and market event notifications. Lead the analysis and generation of ... initiatives and continuously improve the..
Job Information Humana Senior Accreditation Professional in Metairie Louisiana Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with ..
... people everywhere, including our associates, lead their best lives. We support ... we serve, including our associates, lead their best lives. We support ... of operational development and performance..
Description The Senior Risk Management Professional will be responsible for managing third party risk management (TPRM) work streams to support Humana's overall TPRM Program. Responsibilities include risk identification, data analysis, process ..
Job Information Humana Actuary, Risk and Compliance in Metairie Louisiana Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..
Description The Staff Clinical Pharmacist manages the formulary processes for the Clinical Formulary Administration team for the Medicaid LOB. The Staff Clinical Pharmacist work assignments involve moderately complex to complex issues ..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
... experience in program management to lead and manage a team of ... problems within department(s), and could lead multiple managers or highly specialized ... with strong ability to influence,..
... to enhance the clinical delivery process. The National Medicaid Director of ... clinical strategy and provide ongoing process improvement support for Care Management practice; ... support for Care Management..
Description As Lead Actuary of the Risk Predictive Models team, you have an opportunity to both learn more about predictive analytics and machine learning and to see it become very real ..
Description Humana has articulated a long-term vision to transform from a health insurance company to a health services company distinguished by the prioritization of the health outcomes and care experiences of ..
Description Humana is a Fortune 60 healthcare company with a history of successful innovation and reinvention, with over 50 years as a proven leader and innovator in the health and wellness ..
