Healthcare Outcomes Jobs in Riverton

Job Information Humana Medicaid Encounters Lead (Medicaid) - Remote, US in Riverton Wyoming Description The Medicaid Encounters Lead is responsible for monitoring and oversight of the end-to-end encounter management workflow for ..

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

Description The Behavioral Health Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families ..

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 ..

Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Riverton Wyoming Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..

Job Information Humana RN Care Manager--Compact License Required-WAH Nationwide in Riverton Wyoming Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements ..

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 ..

Job Information Humana Bilingual Spanish RN Care Manager--Compact License Required-WAH Nationwide in Riverton Wyoming Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..

Description Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. ..

Job Information Humana Telephonic Behavioral Health Care Manager in Riverton Wyoming Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or ..

Description The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. This position will work and collaborate with ..

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 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 Care Coordinator, 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 facilitate interaction ..

Description The Senior Security Professional protects the organization's employees, properties, and all items of value on premises from any preventable harm or danger. The Senior Security Professional work assignments involve moderately ..

Job Information Humana Director, Informatics in Riverton Wyoming Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..

Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..

Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Riverton Wyoming Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..

Job Information Humana RN Care Manager--Compact License Required-Spanish Bilingual a plus-WAH Nationwide in Riverton Wyoming Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' ..

Job Information Humana Senior Copy Writer in Riverton Wyoming Description Humana's The Hive is looking for a Senior Copy Writer to join the team! The Hive is Humana's in-house agency, a ..

Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..

Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..

Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness by guiding members/families toward resources appropriate for the ..