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Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ..
Description The Behavioral Health Care Coordinator, in a telephonic environment, assesses ... members. The Behavioral Health Care Coordinator’s work assignments are varied and ... Description The Behavioral Health Care Coordinator..
Description The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs administrative/operational/customer support/computational tasks. Typically works within a framework ..
Description Responsibilities The Quality Improvement Lead provides strategic leadership for Humana's South Carolina Medicaid Quality Program, in alignment with organizational quality and population health goals and ensuring compliance with all contract, ..
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 ..
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 ..
Job Information Humana Manager of Fraud and Abuse Data Analytics in Lancaster South Carolina Description Responsibilities The Manager of Fraud and Abuse Data Analytics will be responsible for the supervision of ..
Job Information Humana Medical Director of Long Term Care, Florida in Lancaster South Carolina Description The Long Term Care Medical Director supports the Long Term Care program in meeting optimal member ..
... with Field Operations to address network inadequacy, and document barriers to ... with leaders for collaboration with network & non-network partners. Coordinate and track outcome ... Electronic Questionnaire for..
