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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 Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Charlotte North Carolina Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
... 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..
... Concord, NCnDuration: Permanent PositionnLicensure: NCnnMPLT Healthcare is currently looking for physicians ... Pediatrician to their teamn Established practice, stable group, esteemed colleaguesn Growth ... Please inquire within!nnAbout MPLT HealthcarennnnMPLT..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
... Charlotte North Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Pediatric Hospitalist US-NC-Statesville Job ID: 2023-38357 Type: Physician - Pediatrician/Pediatric Hospitalist # of Openings: 1 Category: Physician NCIRMH Overview Live in the heart of Suburbia! Pediatrix Medical Group is seeking an ..
Description The Director, Physician Leadership relies on medical background and reviews health claims. The Director, Physician Leadership requires an in-depth understanding of how organization capabilities interrelate across the function or segment. ..
About this role: As a Home Therapies Registered Nurse, you will manage patient care in an independent home therapy program by providing education and support to patients and caretakers who have ..
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 ..
... Humana Lead Product Manager - Healthcare API in Charlotte North Carolina ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
FULL TIME POSITION Genesis Rehab Services is a leading provider of Physical, Occupational, Speech and Respiratory Therapy for older adults in skilled nursing facilities, independent and assisted living communities, CCRCs, Transitional ..
Job Description We have an exciting role as an Ancillary Nurse with Minute Clinic. In this new role you will be in an important role as part of the clinic team. ..
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 ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
... Charlotte North Carolina Description The Healthcare Quality Reporting & Improvement (HQRI) ... clinical industry representative. As a leader, this role leads HQRI's Provider ... guidance to ensure physician 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 Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
