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... 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..
... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... customer service. The Clinical Account Manager (CAM) is directly responsible for ... assigned client(s). The Clinical Account..
Description Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will assess, plan, coordinate, implement, ... capacity for self-care to enhance quality..
... 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 Jersey City New ... Jersey Description The Behavioral Health Quality Lead will report directly to ... directly to the National Medicaid..
Description The Learning Facilitation Professional 2 (LFP2) plans, coordinates, conducts or facilitates learning experiences for Humana Military associates and/or external audiences. The LFP2 creates an environment that is conducive to learning ..
... 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..
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 ..
... 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..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Jersey City ... in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be ... Stars Program...
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 ..
Job Information Humana Senior Stars Improvement, Clinical Professional (RN/LPN) - Remote NY, NJ, CT ... Jersey Description The Senior Stars Improvement, Clinical Professional (RN/LPN) role focuses on clinical and .....
... 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..
... 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..
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..
... Peritoneal Dialysis Registered Nurse (PD RN), you will be providing education ... whole patient. As a case manager, you will also track and ... Requirements: * Current Registered Nurse..
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 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..
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 ..
Job Information Humana Senior Stars Improvement, Clinical Professional (RN/LPN) - Remote NY, NJ, CT, ... Jersey Description The Senior Stars Improvement, Clinical Professional (RN/LPN) role focuses on clinical and .....
... (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..
