Clinical Jobs in Riverton

Description The Senior Clinical Business Professional manages all aspects ... and within budget. The Senior Clinical Business Professional work assignments involve ... variable factors. Responsibilities The Senior Clinical Business Professional..

Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..

Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..

Description Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. ..

Description The Process Improvement Lead analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Lead works on problems of ..

Description The Intern - General 2 performs duties in field of study or profession. The Intern - General 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..

Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..

Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Riverton Wyoming Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..

Description The Manager, Fraud and Waste, Genetic Counseling provides clinical support for investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works within specific guidelines ..

Description The Senior Clinical Fraud and Waste Professional performs analysis of clinical investigations of allegations of fraudulent and abusive practices. The Senior Clinical Fraud and Waste Professional work assignments involve moderately ..

Description The Care Management Support Assistant contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..

... Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity ... needed. Acts as the oncology clinical subject matter expert for all ... subject matter expert for all..

... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations,..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Riverton Wyoming Description Humana is looking for an experienced Healthcare Investigator to join its industry ..

Job Information Humana Nurse Advice Line Telephonic Nurse - RN Compact License States Only in Riverton Wyoming Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and ..

Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..

Description The Director, Clinical Pharmacy Drug Evaluation and Policy ... Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T ... and providers. Responsibilities The Director, Clinical Pharmacy Drug..

Description The Technology Solutions Principal works across technology and business (both strategy and operations) teams to build an effective strategy for executing and delivering on combined initiatives. The Technology Solutions Principal ..

Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. Responsibilities The hours are Monday to Friday ..

... Develop strategic initiatives for overseeing clinical integrity, especially for utilization and ... developing standards of care and clinical analytics, and serve as a ... oversight and activities. Represent the..

... Humana RN, Senior Stars Improvement, Clinical Professional in Riverton Wyoming Description ... a RN, Senior Stars Improvement, Clinical Professional who will be responsible ... Program. The Senior Stars Improvement,..

Description The Network Operations Coordinator 3 manages provider data including but not limited to demographics and contract accuracy. Additional Information - How we Value You Benefits starting day 1 of employment ..

... guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) ... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations,..