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... to the Quality Indicators and Outcomes and Quality Assessment and Improvement ... affect rehabilitation and optimal treatment outcomes as part of the comprehensive ... collaboration with the patient and..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision ..
... 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 The Senior Pharmacy Clinical Advisor requires a broad understanding of pharmacy, managed care, PBM, market and regulatory insights to develop, and/or implement formulary strategies to mitigate cost trend and improve ..
Job Information Humana Telephonic Social Worker, Care Manager in Honolulu Hawaii Description The Telephonic Social Worker, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain ..
Description The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization, with a focus on oncology requests. The Oncology ..
DescriptionLend direction as well as a caring attitude. Bring a smile and your vital knowledge to everyone every day. Brighten prospects for patients and your career. Connect with your goals and ..
POSITION FEATURES:Able to Float to all Hawaii Clinics and including GuamPURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program ..
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 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 ..
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 ..
DescriptionProvide your personal attention and kindness, professional insight, and a generosity of spirit. Offer expertise and encouragement. Enhance each patient's future-as well as your own. Connect with your goals and change ..
Job Information Humana Telephonic Behavioral Health Care Manager in Honolulu Hawaii Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or ..
Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..
Description The Behavioral Health Care Manager, Telephonic Nurse, 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 ..
... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... departments, Humana colleagues and the..
