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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 ..
... Health Parity, Clinical compliance, and quality performance and staffing management. Detailed ... Audit team to assure high quality and compliant care is delivered ... business related field; *Active clinical..
... for inpatient cases. Participate in Quality Operations including Quality Management Committee, monitor initial peer ... monitor initial peer review on quality of care complaints Participate in ... of Humana..
Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana. Responsibilities ..
... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... an account or branch for quality assessment, education and clinical training, ... and clinical training, and process..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - ... Horizons is seeking a Senior Quality Program Delivery Professional who will ... who will manage and support quality improvement..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Davenport Iowa ... in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be ... Stars Program...
Description The Quality Compliance Professional 2 completes annual ... Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments ... courses of action. Responsibilities..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... and other military healthcare programs. High-quality service, cost-effective platforms, and progressive ... Government. Responsibilities The Telephonic Care Manager will..
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 ..
... and other military healthcare programs. High-quality service, cost-effective platforms, and progressive ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary. The PDC Care..
... The registered professional nurse (CAP RN 1) position is an entry ... for Registered Nurses. The CAP RN 1 is accountable and responsible ... health care team, the CAP..
... (CCM) organization is seeking a Manager, Fraud & Waste to join ... As the Fraud & Waste Manager at Humana, you will support ... so that our members receive..
... on medical record documentation for quality and clinical compliance with contract ... CPT Codes. KEY ACCOUNTABILITIES 95% Quality Monitoring Audits Review and assess ... (LPC), Psychologist (PhD), Registered Nurse..
... Healthy Horizons have access to quality care for their behavioral health ... as a key leader in quality improvement oversight and activities. Represent the ... Marriage and Family Therapist..
... Humana Nationwide Medicaid Behavioral Health Quality Lead in Davenport Iowa Description ... Iowa Description The Behavioral Health Quality Lead will report directly to ... directly to the National Medicaid..