Healthcare Business Systems Analyst Jobs

Job Information Humana Clinical Recruiter 2 - VSP in Honolulu Hawaii Description The Clinical Recruiter 2 interviews prospective employees for hourly and salaried positions. Assists with Pharmacy recruiting from entry level ..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Honolulu Hawaii Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Description The Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..

... interdependencies between technology, operations and business needs. Required Qualifications Bachelor's degree. ... (3) years of experience in healthcare quality. Understanding of healthcare quality improvement strategies such as ... Model..

... as a focus on collaborative business relationships, value based care, population ... whether services provided by other healthcare professionals are in agreement with ... management organizations, hospitals/ Integrated Delivery..

Job Information Humana Senior Clinical Recruiter in Honolulu Hawaii Description The Senior Clinical Recruiter recruits qualified applicants for staff nurse or other positions requiring registered nurse licensure, licensed practical nurse, or ..

... document all encounter errors in systems/databases; perform encounter data reconciliation and ... departments on designing and implementing system/business process adjustments as needed to ... Qualifications Bachelor's degree in a..

... of services provided by other healthcare professionals in compliance with review ... management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. ... Health,..

Job Information Humana IAM Senior Data Engineer in Honolulu Hawaii Description The Senior Data Engineer Designs, builds, and maintains data processing architectures and solutions enabling the efficient conversion of structured and ..

... and recovery on Database Management Systems, configures database parameters, and prototype ... by database size, technology used, systems feeds and interfaces) with multiple ... calls with multiple IT and..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Honolulu Hawaii Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Honolulu Hawaii Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..

... hospice and palliative care pharmacy business acquired by Humana in 2021. ... by adjusting/correcting authorizations in dispensing systems and PBM systems Ensure timely adjudication of prescription ... of prescription..

... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... management organizations, hospitals/ Integrated Delivery..

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 ..

... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... management organizations, hospitals/ Integrated Delivery..

... Develop features, user stories and business requirements Improve coordination over cross-functional ... data pipelines, algorithms, and automated systems. Responsibilities The Senior Product Management ... functional partners, market partners, and..

... with other analytics, IT and business areas across the organization to ... and delivering on Health Informatics business initiatives. The Director of Health ... with other analytics, IT and..

Job Information Humana Senior Product Management Professional in Honolulu Hawaii Description The Senior Product Management Professional must be able to lead, plan and track all phases of the product life cycle, ..

... measures the effectiveness of existing business processes and develops sustainable, repeatable ... develops sustainable, repeatable and quantifiable business process improvements. The Senior Process ... Team's quality program Research best..

... measures the effectiveness of existing business processes and develops sustainable, repeatable ... develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement ... Process Improvement Lead researches best..

... between IT and the aligned business group(s). The Lead manages our ... Development Team, facilitates guidance to business partners on information technology (IT) ... leverages industry trends, and challenges..

Description The Market Development Professional 2 provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Market Development ..