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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 Network Operations Lead maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. The Network Operations Lead ..
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 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 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 Centerwell Nurse Practitioner, Implementation and Training Team in Brentwood Tennessee Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's ..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Brentwood Tennessee Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business ..
Job Information Humana Medicare/Medicaid Program Manager -- Remote in Brentwood Tennessee Description Humana's Enterprise Shared Services organization is seeking an outstanding cross-functional program leader to join its Business Management team. This ..
... Advisor - Medicaid Provider Service Operations in Brentwood Tennessee Description The ... Advisor - Medicaid Provider Service Operations provides support to assigned health ... to Medicaid Group product implementation,..
Description The Telephonic Nurse Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
... 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,..
Job ID 21000LNVAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
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,..
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 ..
Job Information Humana Enterprise Risk Management Lead-US-Remote in Brentwood Tennessee Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..
Job Information Humana VP, Clinical Operations in Brentwood Tennessee Description VP, ... Brentwood Tennessee Description VP, Clinical Operations and Chief Clinical Officer of ... of the Home Health clinical operations...
... with physicians, other nurses and healthcare professionals to provide care, monitor ... medical equipment, perform minor medical operations, and advise patients and their ... is a national leader in..
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 ..
... 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..
Job Information Humana Senior Strategy & Program Development Professional (Remote) in Brentwood Tennessee Description Responsibilities Humana's Corporate Marketing team is looking for a Senior Strategy & Program Development Professional to join ..
Job Information Humana Market Network Operations Lead (Behavioral Health) - KY ... Description The Behavioral Health Network Operations Lead will be our Subject ... claims data needed for service operations...
Job Information Humana Network Operations Lead - Behavioral Health/Medicaid in ... Brentwood Tennessee Description The Network Operations Lead maintains provider relations to ... claims data needed for service operations. The..
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..