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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..
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... 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 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..
... 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..
... 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 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..
... 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..
Job Information Humana Process Improvement Lead South Carolina Medicaid (Utilization and Case Management) in Charlotte North Carolina Description ... Charlotte North Carolina Description The Process Improvement Lead analyzes, and measures..
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..
Job OverviewProject Management Analysts (PMA) are an integral ... Project Manager (CPM) driving project management activities to mitigate risk, control ... and leads risk and issue management process. Schedules and..
... 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..
... 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..
