Healthcare Performance Improvement Jobs

... all areas impacting DCE operations, performance, experience, and outcomes including provider ... as they relate to provider performance, beneficiary experience, DCE growth, provider ... engagement strategy, identifying and implementing..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Honolulu Hawaii Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... Hawaii Description The Senior Process Improvement Professional analyzes, and measures the ... process improvements. The Senior..

Job Information Humana Senior Corporate Strategy Analyst in Honolulu Hawaii Description Humana's Corporate Stragtegy team is a high-performing organization that works closely with Humana's senior leaders to help chart the course ..

Job Information Humana Quality Improvement Coordinator in Honolulu Hawaii Description ... Honolulu Hawaii Description The Quality Improvement Coordinator 3 assists in administering ... in administering and monitoring quality improvement and..

... 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..

Job Information Humana Healthcare Services Senior Learning Design Professional-Remote ... solution to a knowledge or performance gap. The Senior Learning Design ... variable factors. Responsibilities The HCS (Healthcare Services) Learning..

... 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..

... the global leader in dialysis healthcare: Fresenius Medical Care North America. ... we advance careers and the healthcare of countless individuals. Why Join ... a promising career with a..

Job Information Humana Lead - Technology Solutions Encounters in Honolulu Hawaii Description Humana Medicaid is growing and you have the unique opportunity to grow with us! Join our team and propel ..

... will manage and support quality improvement program strategies and implementations. The ... strategic objectives related to quality improvement, operations, and analytics. Utilize data ... implement evidence-based quality and process..

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 ..

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 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 ..

... the project; monitors progress and performance against the project plan; takes ... completing projects Monitor progress and performance against the project plans and ... Qualifications 3-5 years of relevant..

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 ..

... 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..

Job Information Humana Corporate Strategy Consultant in Honolulu Hawaii Description Humana's Corporate Stragtegy team is a high-performing organization that works closely with Humana's senior leaders to help chart the course for ..

... of care. The Senior Process Improvement Professional analyzes, and measures the ... process improvements. The Senior Process Improvement Professional work assignments involve moderately ... data and platforms for process..

Job Information Humana Medicare Appeals and Grievance Medical Director in Honolulu Hawaii Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

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 ..

... drive the understanding of financial performance and key drivers o Responsible ... and leadership of medical cost improvement initiatives o Responsible for the ... resources of technical knowledge and..

... and medication related Star measure performance. The Pharmacy Clinical Advisor Professional ... Responsibilities The Project Manager, Financial Healthcare Advisor manages all aspects of ... with metrics reporting and program..