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... 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..
... 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..
... 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..
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... 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 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..
... 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..
Description The Clinical Pharmacy Lead monitors drug development pipeline, and ... health outcomes. The Clinical Pharmacy Lead works on problems of diverse ... is responsible for client cost management and..
... 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..
... 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 .....
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..
... practice of Quality Assessment and Improvement (QAI), including use of FMS ... individual contributor will have significant project/process responsibilities. Program or project responsibility ... and develops a mechanism or..
... 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..
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..
... 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..
... 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..
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..
... Nurse: Serves as a team lead and subject matter expert (SME) ... CarePlus departments Leads implementation of process improvement initiatives based on data analysis ... Reviews inventory reports and..
... 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..
