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Description Humana's National Medicaid Quality team is seeking a Market Consultant to be responsible for supporting individual Medicaid market quality teams and serving as the main relationship broker and liaison to ..
Description As the Associate Director, IT Project Management, you will use your background and experience in program management to lead and manage a team of PMO professionals that support the delivery ..
Job Information Humana Healthcare Services Senior Learning Design Professional-Remote ... variable factors. Responsibilities The HCS (Healthcare Services) Learning and Curriculum Senior ... years of experience in performance consulting, Instructional Design..
... Newport Rhode Island Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... corporate strategic initiatives. Responsibilities The..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
... The Strategy Operations team provides consulting services to Humana's lines of ... Required Qualifications 2-5 years of consulting, corporate strategy, (or data/business analysis ... Data Science, Data Analytics, etc.)..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate ..
Job Information Humana Senior Innovation Portfolio Strategy Professional in Newport Rhode Island Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives ..
... the mission of a leading healthcare company committed to improving the ... care strategist with responsibility for consulting with executive leadership to synthesize ... possess working knowledge of contemporary..
Job Information Humana Strategy Advisor, Healthcare Strategy in Newport Rhode Island ... Island Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..
Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Description Responsibilities The Senior Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. Translates business needs into technical systems solutions. Integrates ..
Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..
Job Information Humana Associate Vice President, Quality Improvement for ... a clinical environment or within healthcare operations 5 or more years ... operations 5 or more years Healthcare or Managed..
... and overall strategic positioning. This associate will also collaborate closely with ... health care trade association, a consulting/lobbying firm engaged in health policy, ... 5 or more years of..
Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..
Job Information Humana Manager, Fraud and Waste-Remote US in Newport Rhode Island Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
... Newport Rhode Island Description The Healthcare Quality Reporting & Improvement (HQRI) ... its Provider Support team and associate's responsibilities. HQRI is an organization ... operations, and performance nationally. The..
Job Information Humana Healthcare Strategy Consultant in Newport Rhode ... Newport Rhode Island Description The Healthcare Strategy Consultant provides data-based strategic ... Responsibilities Humana, a Fortune 60 Healthcare Company Humana..
