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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..
... 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..
... 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..
... 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..
... 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..
... 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..
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..
... 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..
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..
... a week.***nnAbout the Opportunity:nntSpecialty: Case Management / Utilization ReviewntSchedule: Monday to FridayntPatient Population: ... clinical guidelines, and overall workflow improvement strategiesntConducting both standard regulatory auditsntMonitoring ... the rest of..
... 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..
... 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..
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..
... 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..
... and values. Links the quality management activities to business goals. Proactively ... influence business strategies. Responsible for management of a variety of quality ... of a variety of quality..
