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Description The Senior STARS Improvement Professional develops, implements, and manages oversight of the company's Medicare/Medicaid Stars Program. Directs all Stars quality improvement programs and initiatives. The Senior STARS Improvement Professional work ..
Job ID 21000LJWAvailable Openings 1 PURPOSE AND SCOPE: Ensure the provision of quality patient care to all hospitalized patients in the most efficient manner in accordance with company policy. Provides direct ..
... departments on designing and implementing system/business process adjustments as needed to ... Qualifications Bachelor's degree in a healthcare field or equivalent experience. 5 ... years of experience in managed..
Description Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
... client's products and build lasting business relationships. Such talent and passion ... territory, and more specifically:nnMaximize new business opportunities with physician groups and ... years of experience selling to..
Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..
... lead cross-functional stakeholders to gather business requirements and effectively implement change, ... that support the specialty pharmacy business. Key Responsibilities Owns the end-to-end ... regional medical directors, lawyers, actuaries,..
... Information Humana Senior Corporate Strategy Analyst in Jacksonville Florida Description Humana's ... growth opportunities and work with business leaders to prioritize strategic investments ... services to Humana's lines of..
... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable healthcare while keeping our provider networks ... data, statistical analysis, problem solving,..
Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..
Job Information Kindred at Home RN Clinical Manager in Jacksonville Florida The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. Develops, plans, implements, analyzes, and ..
Description The Lead Cloud Architect leads the planning, design, and engineering of enterprise-level infrastructure and platforms related to cloud computing. The Lead Cloud Architect works on problems of diverse scope and ..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
... growth opportunities and work with business leaders to prioritize strategic investments ... services to Humana's lines of business on a project basis. As ... their strategies and solve complex..
... CarePlus is seeking a Clinical Business Lead who will lead teams ... and Utilization Management. The Clinical Business Lead works on problems of ... to substantial. Responsibilities The Clinical..
... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable healthcare while keeping our provider networks ... knowledge of data, statistical analysis,..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
