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... Humana is seeking an experienced management professional to lead an interactive team with broad ... member's health outcomes and costs Lead Humana's formulary and medical drug ... clinical drug..
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... (YHA) is a Humana-owned Healthcare Management Company dedicated to improving clinical ... are at risk of excessive utilization of future health related services ... care in their home. This..
Description The Utilization Management Nurse 2 utilizes clinical nursing ... and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... state RN licensed required The Utilization Management..
... performance support, mobile learning and process documents. Plans, organizes, and collaborates ... proficiency testing, and job performance improvement. Makes decisions on moderately complex ... any field Minimum 1 year..
... education opportunities to drive maximum utilization of available resources, and directing ... problems within department(s), and could lead multiple managers or highly specialized ... highly specialized professional associates. Responsibilities..
... will work closely with Care Management leaders and Subject Matter Experts ... in the areas of Case Management, Utilization Management and Care Management Support as well as other .....
... The ACD Referral Authorization Coordinator Lead role will assist the Supervisor ... (ACD). Under direct clinical supervision, process referrals from Military Treatment Facilities ... include data entry into medical..
... development and implementation of quality improvement interventions and audits and assists ... of experience in Accreditation, Quality Management, Compliance, Utilization Management, Behavioral Health, and/or Case Management Exceptional analytical and..
... to feedback and recommendations by Utilization Review staff. Upon completion of ... courses of action through the utilization of Performance Improvement principles. Responsible for review of ... the QA/PI..
... to enhance the clinical delivery process. The Director of Health Services ... leads Medicaid shared services operational process and teams responsible for supporting ... and leading the Centralized Outpatient..
Description Humana's Enterprise Clinical Management team needs your clinical, business ... various analytical organizations you will lead the clinical review and development ... indicators. Secondly, this role will lead the..
... Ensures accuracy of formularies and utilization management (UM) criteria in the Formulary ... and Therapeutics Committee and Drug Utilization Review team meetings Collaborates with ... an expert in Humana's..
Description Account Management Lead defines the account management strategy for Humana Pharmacy's commercial ... Pharmacy's commercial accounts. The Account Management Lead works on problems of diverse ... are developed. Leads..
... of the Clinical Drug Policy Management team which ensures synchronization of ... which ensures synchronization of formulary utilization management policies across multiple systems. Humana ... Active, unrestricted pharmacy licensure..
Description The Process Improvement Lead analyzes, and measures the effectiveness ... sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of diverse ... moderate to..
Description The Lead Behavioral Health Medical Director oversees ... doing case reviews themselves. The Lead Behavioral Health Medical Director may ... Health Medical Director may also lead specific functional area..
... leader on LTC population health management and the integrated health model, ... through the Peer 2 Peer process, and in some instances these ... health, or disease or care..
... Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure ... to enhance the clinical delivery process. The Associate Director, Compliance Nursing ... problems within department(s), and..
... Understand and engage in risk management procedures such as identifying, coordinating, ... standards; Participate in all quality improvement procedures and adhere to quality ... procedures and adhere to quality..
... meetings with Humana's CEO and management team and frequently deliver strategy ... role is modeled after top-tier management consultant experience. As such, day-to-day ... lines of business to reduce..
