Healthcare Operations Jobs in Troy

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. ..

... 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 Network Operations Lead - Behavioral Health/Medicaid in ... Troy Michigan Description The Network Operations Lead maintains provider relations to ... claims data needed for service operations. The..

Details Department: Ascension Care Operations - Insurance Schedule: 8-hour day ... the client. Strong Knowledge of healthcare claims, Medicaid, Medicare, Pharmacy benefits, ... background, preferred 1 years of healthcare experience,..

Job Information Humana Enterprise Risk Management Lead-US-Remote in Troy Michigan Description The Sales Conduct Risk Management Lead a critical member of Humana's Third Party Risk Management Program (TPRM), a 2nd Line ..

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 Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Troy Michigan Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business ..

Job Information Humana Senior Strategy & Program Development Professional (Remote) in Troy Michigan Description Responsibilities Humana's Corporate Marketing team is looking for a Senior Strategy & Program Development Professional to join ..

Job Information Humana VP, Clinical Operations in Troy Michigan Description VP, ... Troy Michigan Description VP, Clinical Operations and Chief Clinical Officer of ... of the Home Health clinical operations...

... 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..

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 ..

... Advisor - Medicaid Provider Service Operations in Troy Michigan Description The ... Advisor - Medicaid Provider Service Operations provides support to assigned health ... to Medicaid Group product implementation,..

Job Information Humana Medicare/Medicaid Program Manager -- Remote in Troy Michigan Description Humana's Enterprise Shared Services organization is seeking an outstanding cross-functional program leader to join its Business Management team. This ..

... in Troy Michigan 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 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 ..

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 ..

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 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 ..

... 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,..

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 ..