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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 ..
Description Your Home Advantage (YHA) is a Humana-owned Healthcare Management Company dedicated to improving clinical and quality outcomes by bridging the gap between the physician's office and the member's home. YHA ..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
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). ..
... Humana is a Fortune 60 healthcare company with a history of ... top place to work in healthcare, especially in areas of Diversity ... a personalized, seamless and easy..
Job Information Humana Manager, Fraud and Waste-Remote US in ... in Birmingham Alabama Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments ... action. Responsibilities The RN Care Manager, Telephonic Nurse..
... As the Associate Director, IT Project Management, you will use your ... appropriate to meet program and project needs, mitigating overall delivery risk, ... and reporting on program and..
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 ..
Job Information Humana Product Manager Lead, Pharmacy Transformative Products Team, ... 60 market leader in integrated healthcare with a clearly defined purpose ... us redefine the future of healthcare. With..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
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 ..
Job Information Humana Manager, Care Management Social Services-WAH Nationwide ... Description Job Description Summary The Manager, Care Management leads teams of ... multi-disciplinary care management team. The Manager, Care Management..
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... schedules and goals. Responsibilities The Manager, Care Management oversees..
Description The Director of Health Services for National Medicaid Clinical Operations utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Director, Health ..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare ... Alabama Description The Lead Product Manager Conceives of, develops, delivers, and ... customer use. The Lead Product..
... of services provided by other healthcare professionals in compliance with review ... issues regarding technical approach for project components, and work is performed ... whether services provided by other..
... the mission of a leading healthcare company committed to improving the ... planning, structured problem solving, and project management rigor. We are a ... care strategist with responsibility for..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..