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Description The Care Management Support Assistant 3 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 ..
... health (BH)/Substance Use Disorder (SUD) clinical quality performance measures to achieve ... Behavioral Health Director, Quality Improvement Manager and those targeting specialized behavioral ... Professional is responsible for improving..
Description Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Job Information Humana Care Manager, Telephonic Nurse 2 Certified Diabetes ... bridge the gap and integrate clinical and self-management aspects of diabetes ... active decision makers with their clinical treatment..
Description The Care Management Support Assistant 2 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 ..
Description The Director, Clinical Pharmacy Drug Evaluation and Policy ... Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. ... and providers. Responsibilities The..
... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... innovations, flexible medication access, one-on-one clinical support, and excellent customer service. ... the Pharmacy Claims (Support Services)..
Job Information Humana Director, Informatics in Charleston West Virginia Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights ..
Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that maximize customer value to create a differentiated value proposition for Humana ..
Description The 'voice of the provider' is key to Humana's integrated care delivery strategy. As Humana evolves from being recognized as a traditional payer to a health care company with deep ..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Job Information Humana Care Manager, Telephonic Nurse 2-Remote (Eastern Standard ... West Virginia Description The Care Manager, Telephonic Nurse 2, in a ... wellbeing of members. The Care Manager, Telephonic..
Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Charleston West Virginia Description Humana is looking for an experienced Healthcare Investigator to join its ..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Charleston West Virginia Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..
