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... 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..
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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..
... 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..
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..
... 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..
... 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..
... 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..
... 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..
... 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..
... care model, where our physicians lead a multi-disciplinary care team supporting ... motivating, and retaining organizational talent Lead medical center operations consistent with ... initiatives, Hedis/Star gap closure 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..
... Louisiana is seeking a Manager, Utilization Management (Behavioral Health) who will utilize ... benefit administration determinations. The Manager, Utilization Management Behavioral Health applies a Person-Centered ... Essential Functions and..
... meet regulatory compliance. Leads Performance Improvement projects, serves as clinical nutrition ... when in serving in a management lead role.Preferred: Masters with Additional Board ... of clinical experience 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..
... 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..
... 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..
