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Program Manager-Patient Safety, Quality, Risk and Safety, ... MARY AND ELIZABETH HOSP.','','!*!The Program Manager, Patient Safety coordinates the patient ... optimize patient safety. The Program Manager, Patient Safety is responsible..
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Division Manager Pharmacy 340B Program','Full-time','Professional Non-Clinical','1','1','80','80','Occasional','Occasional','KENTUCKY-LEXINGTON-SAINT JOSEPH ... Summary The Division 340B Program Manager leads, coordinates, and supports the ... Team, the Division 340B Program Manager works closely with Division..
Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... you succeed, we succeed! The Manager, Utilization Management Nursing..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
... provider experience, as well as project manage the market rollout end-to-end. ... Medicaid markets Create and manage project plans to ensure effective and ... and timelines for provider services..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
PURPOSE AND SCOPE:Functions as part of the Staff Assisted Home Hemodialysis Health Care Team by providing safe and effective dialysis therapy for patients in the skilled nursing homes. Works under the ..
Job Description The Director, Quality and Process Improvement is responsible for oversight of all quality initiatives to include monitoring quality metrics at the unit level. This position oversees regulatory readiness through ..
... Leadership experience 1 year of Project Management or Quality Improvement experience ... unit level. This position oversees regulatory readiness through assessment and implementation ... implementation of measures to meet..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
... Compliance Program, including following all regulatory and FMS policy requirements. Ensure ... with all legal, compliance, and regulatory requirements and programs. Adheres to ... standards through meeting all ESRD..
... seeking a HEDIS Senior Data Manager to deliver quality and value ... Responsibilities The HEDIS Senior Data Manager is accountable for engaging in ... of the HEDIS program and..
Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
Job Information Humana Senior Project Manager -- Remote in Louisville Kentucky ... Louisville Kentucky Description The Senior Project Manager manages all aspects of a ... manages all aspects of a..
Description The Director HEDIS Production and Quality Analytics takes the lead in driving success for key quality measures development and analytic reporting functions that support Humana Military clinical quality strategies, including ..
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 ..
