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Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
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 ..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..
... to the National Medicaid Quality Director, and be responsible for the ... Qualifications Bachelor's degree in Business, Healthcare, or related field. 5 years ... their home. We are a..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..
Description Humana's Primary Care Organization (PCO) is seeking a Senior Product Marketer to join working remote anywhere in the U.S. This marketing professional is responsible for the implementation of marketing strategies, ..
Description The Director of Product Management for Clinical ... business acumen. Responsibilities As the Director of Product Management for Clinical ... insights Bachelor's degree in Business, Healthcare Administration or other..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
... is looking for an Associate Director of Data Science to lead ... adverse health events. The Associate Director must be able to effectively ... problems being encountered. The Associate..
Job Information Humana Associate Director, Technology Solutions in Portland Maine ... in the role of Associate Director, Technology Solutions to as a ... training, etc. Reports to a Director in..
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 ..
... challenge and change.' The Associate Director, Technology Solutions devises an effective ... IT business initiatives. The Associate Director, Technology Solutions requires a solid ... across department(s). Responsibilities The Associate..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
... to the National Medicaid Quality Director. Responsibilities The Quality Improvement Program ... 3 years of experience managing Healthcare Quality programs OR 8 years ... their home. We are a..
Description The Associate Director, Full Stack Engineering Performs software ... at the front-end. The Associate Director, Full Stack Engineering requires a ... for one of the leading healthcare organizations. Reporting..
... contract compliance, and federal contract application submissions. The Market Development Advisor ... This position reports to the Director of Provider Experience and Network ... improvement and project management Supports..
Job Information Humana Associate VP, Clinical Pharmacy (Remote) in Portland Maine Description The Associate VP, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support and strategy to ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Portland ... Portland Maine Description The Associate Director, Utilization Management Nursing utilizes clinical ... benefit administration determinations. The Associate Director,..
Job Information Humana Associate Director, Site Reliability Engineering in Portland ... Portland Maine Description The Associate Director, Site Reliability Engineering maintains, integrates ... within the organization. The Associate Director, Site..
