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Description The Senior Quality Improvement Professional will focus organizational efforts ... Use Disorder (SUD) clinical quality performance measures to achieve optimal performance and quality for the Humana ... Director, Behavioral..
... and actively participates in process improvement activities that enhance the likelihood ... competency evaluations/audits to ensure ongoing performance of other PCT’s. Collaborates with ... the practice of Continuous Quality..
Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) ... Horizons is seeking a Quality Improvement Program Lead who will be ... Humana Healthy Horizon's National Quality Improvement (QI)..
... all levels and drive increased performance. Perform and monitor routine audits ... audits to ensure successful quality performance outcomes and compliance standards Develop ... plan of action for process..
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 Physician Performance Insights team's mission is to ... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable healthcare while keeping..
... development and implementation of quality improvement interventions and audits and assists ... priorities Commitment to continuous process improvement Exceptional verbal and written communication ... minimum standard speed for optimal..
... The mission of the Physician Performance Insights team is to empower ... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable..
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 ..
... encounter data, submission requirements and performance metrics per regulatory and health ... for error resolution, follow-up and performance monitoring. Participate in resolving encounter ... Qualifications Bachelor's degree in a..
Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
... social determinants and obtaining timely healthcare. The Lead Medical Director provides ... of services provided by other healthcare professionals in compliance with review ... with review policies, procedures, and..
Description The Health Information Management Professional 2 ensures data integrity for claims errors. The Health Information Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of ..
Job Information Humana Director, Behavioral Health Strategy in Charleston West Virginia Description The Director, Behavioral Health (DBH) will ensure that populations served by Humana Healthy Horizons have access to quality care ..
... guides, scripts, use case scenarios, performance support, mobile learning and process ... developing training curriculum, materials, job performance aids and programs to meet ... effective learning objectives and coordinates..
... 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... operational metrics that systematically measure..
Genesis a leading provider of healthcare services from short-term to long-term ... department.Foster an environment of continuous improvement and mentor staff to achieve ... include but not limited to performance..
Job Information Humana Quality Improvement Coordinator in Charleston West Virginia ... West Virginia Description The Quality Improvement Coordinator 3 assists in administering ... in administering and monitoring quality improvement and..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..
