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... Medical Center Location Details: Carolinas HealthCare System is Atrium Health. Our ... *Collects data pertinent to the healthcare consumer's health or the situation. ... a plan individualized to the..
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 ..
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. ..
... 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 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 ..
PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP RN 1 is accountable and ..
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) ... clinical industry representative. As a leader, this role leads HQRI's Provider ... guidance to ensure physician and..
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 ..
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 ..
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 ..
... 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..
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 ..
Pediatric Hospitalist US-SC-Fort Mill Job ID: 2022-36142 Type: Physician - Pediatrician/Pediatric Hospitalist # of Openings: 1 Category: Physician SCPDFM Overview Great opportunity to join a dynamic group in desirable, Charlotte/Ft. Mill ..
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 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 ..
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 ..
... policy, procedures, standards of nursing practice, state and federal regulations. Performs ... as indicated and notifies Team Leader, Charge Nurse, Clinical Manager or ... and family. Serves as a..
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 ..
PURPOSE AND SCOPE:Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality patient ..
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 ..
... for a large provider group practice, physician practice management organization, hospital/hospital system, or ... (preferably with a physician group practice component) Strong knowledge of MA ... patients with understanding..