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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
Description The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. ..
Job Information Humana Medicare/Medicaid Program Manager -- Remote in Aberdeen South Dakota Description Humana's Enterprise Shared Services organization is seeking an outstanding cross-functional program leader to join its Business Management team. ..
Job Information Humana Senior Strategy & Program Development Professional (Remote) in Aberdeen South Dakota Description Responsibilities Humana's Corporate Marketing team is looking for a Senior Strategy & Program Development Professional to ..
Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Aberdeen South Dakota Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing ..
... and execute strategic transformation. 'Strategy Operations' is one of a three ... Strategy Planning functions. The Strategy Operations team provides consulting services to ... the other teams in Strategy..
Description The Senior Compensation Professional develops, implements, and administers compensation programs. The Senior Compensation Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..
... the realization of quality, economical healthcare services and other related lines ... Has MHA/MBA/MS in hospital administration, healthcare administration or equivalent educational experience. ... and a working knowledge of..
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 ..
... the advancement of Medicaid Clinical Operations and Programs. Responsibilities Responsibilities of ... a clinical environment or within healthcare operations 5 or more years Healthcare or Managed Care leadership experience,..
... Advisor - Medicaid Provider Service Operations in Aberdeen South Dakota Description ... Advisor - Medicaid Provider Service Operations provides support to assigned health ... to Medicaid Group product implementation,..
Description The Remote Systems Clinical Pharmacist will provide excellent customer service to both internal and external customers by developing and maintaining relationships with Account / Clinical Management and PCO-IPU Operations teams. ..
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 ..
... behavioral health care strategy and/or operations. The Behavioral Health Medical Director ... and clinical guidance for Medical Operations and Market Operations Develop comprehensive care programs for ... programmatic requirements..
Job Information Humana Enterprise Risk Management Lead-US-Remote in Aberdeen South Dakota Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd ..
Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... leadership and external exposure with healthcare providers in OH,..
Job Information Humana Network Operations Lead - Behavioral Health/Medicaid in ... South Dakota Description The Network Operations Lead maintains provider relations to ... claims data needed for service operations. The..
... Aberdeen South Dakota Description The Healthcare Quality Reporting & Improvement (HQRI) ... to Humana's national planning and operations for Risk Adjustment, Stars, and ... national provider education strategy and..
Description The Manager, Fraud and Waste, Genetic Counseling provides clinical support for investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works within specific guidelines ..