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Description Responsibilities The Senior Market/Industry Insights Professional delivers clinical/medical policy insight and information to both internal and external customers for Humana Government Business (HGB). The Senior Market/Industry Insights Professional will draft ..
... for multiple departments, especially utilization management and care management groups. Leverages clinical experience and ... Qualifications Bachelor's degree in Nursing, Healthcare Management or related field Active R.N. ... regulatory..
Description The Director, Health Services utilizes clinical nursing ... and/or benefit administration determinations. The Director, Health Services requires an in-depth ... segment. Responsibilities The SC Medicaid Director, uses clinical knowledge,..
Description The Director, Medical Coding extracts clinical information ... CPT) to patient records. The Director, Medical Coding requires an in-depth ... function or segment. Responsibilities The Director, Medical Coding ensures..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
Job Information Humana Director, Medicaid Strategic Solutions in Charlotte ... the mission of a leading healthcare company committed to improving the ... structured problem solving, and project management rigor. We..
Description Humana's Enterprise Clinical Management team needs your clinical, business ... acumen to solve for the healthcare challenges of today. The Clinical ... organization is seeking a Medical Director of..
... Qualifications A passion for serving high-risk seniors in achieving their best ... with familiarity of HEDIS/STARS, medical risk adjustment, and clinical programming in ... affect patient care and population..
Job Information Humana Director, Behavioral Health Network & Market ... Charlotte North Carolina Description The Director, Behavioral Health (BH) Network and ... model design (full or partial risk, PPPM, upside..
... Information Humana AVP, Stars and Risk Adjustment National Medical Director in Charlotte North Carolina Description ... Charlotte North Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) ... national..
... Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership ... Charlotte North Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) ... that leads Humana's Stars and..
Description The Vendor Quality Medical Director will manage clinical vendor quality ... Responsibilities A full time Medical Director to manage clinical vendor quality ... for inpatient and outpatient utilization management..
... 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... Vice President, Home Care Product..
Description The Chief Medical Officer, Group Medicare relies on the medical background to create and oversee clinical strategy for the Group Medicare business. The CMO Group Medicare, requires and in-depth understanding ..
... 40) market leader in integrated healthcare with a clearly defined purpose ... Responsibilities Key Responsibilities Leverage product management expertise to create simple, personalized ... the moment of need for..
Description As the Associate Director, IT Project Management, you will use your background ... background and experience in program management to lead and manage a ... our Medicare segment. The..
... Mid-Atlantic region. Oversee regional utilization management for case types including but ... necessity determination processes and Medical Director audit processes. . Provide oversight ... contract language related to medical..
... Reviews inventory reports and assists management with data tracking to identify ... providers on utilization and medical management processes. Enters and maintains pertinent ... clinical information in various medical..
... with Market Operations and Utilization Management leaders in each Market on ... of strategic objectives. Drive project management, analysis of data, and strategic ... Directors, Provider Representatives, Physicians, Utilization..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
