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... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... approach to providing strategic thought leadership to identify and address complex ... Claims, Grievance and Appeals, Market..
Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The Pharmacy ..
Job Information Humana Healthcare Services Senior Learning Design Professional-Remote in Anchorage Alaska Description The Senior Learning Design Professional uses instructional design, cognitive psychology and adult learning theory to determine the appropriate ..
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 ..
... 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an accomplished healthcare leader for the newly-created role ... quality, appropriate, and cost-effective behavioral..
Description Humana Medicaid is growing and you have the unique opportunity to grow with us! Join our team and propel Humana forward to solve the technology challenges of tomorrow. You'll collaborate ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, ..
Description The Manager, Medical Coding oversees the coding team that is reviewing inpatient records for appropriate coding to include ICD-10, CPT, and HCPCS. The Manager, Medical Coding works within specific guidelines ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Job Information Humana Strategy Advisor, Healthcare Strategy in Anchorage Alaska Description ... Alaska Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..
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 ..
... responsible for informing Humana's thought leadership, advocacy, and overall strategic positioning. ... of State Affairs and business leadership anticipating legislative and regulatory trends ... 5 or more years of..
... operations in areas of responsibility LEADERSHIP: Provide visionary leadership in the professional practice setting ... setting and the profession. Uses leadership principles to anticipate and influence ... PRACTICE EVALUATION:..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
... for one of the leading healthcare organizations. Reporting to Director of ... by delivering personalized, simplified, whole-person healthcare experiences. The Associate Director, Full ... forecasts (labor and non-labor). Provide..
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 Director, Provider Contracting - Behavioral Health Medicaid in Anchorage Alaska Description The Director, Provider Contracting - Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider ..
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 ..
Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
