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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..
... 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..
... Humana Nationwide Medicaid Behavioral Health Quality Lead in Newport Rhode Island ... Island 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 ..
... 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 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..
... (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..
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 ..
... 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..
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..
... duties as assigned by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to ... to pharmacy errors and the Quality Improvement Program.Strictly adheres to the Walgreen..
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..
... 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..
... 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 Newport Rhode ... 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 ..