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Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
Description The Care Management Support Assistant 2 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 ..
Description Responsibilities The ACD Referral Authorization Coordinator Lead role will assist the Supervisor in oversight & monitoring of processing and timeliness standards for referrals and authorizations under the Autism Care Demonstration ..
Job Information Humana Manager, UM Nursing - Home Solutions UM Team in Louisville Kentucky Description The Manager, Utilization Management Nursing utilizes clinical and leadership skills to support the coordination, documentation and ..
OverviewnThe Quality Improvement (QI) Coordinator supports system-wide improvement initiatives within the facility to ensure effective and timely quality improvement activities within a designated body of work, function, or specific clinical service ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
... Qualifications Bachelor's degree in nursing, healthcare, or related field Prior experience ... 3 years' experience working on healthcare quality and performance measure improvement ... their home. We are a..
OverviewnUnder general direction, responsible for application and integration of information technology in the healthcare setting. This position will serve as a liaison between the IT department and operations to align system ..
Description This is a salaried exempt position with responsibility for utilization management oversight and clinical decision-making as outlined in the Autism Care Demonstration (ACD) defined in the TRICARE Operations Manual Chapter ..
Description The 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 toward and ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Job Information Humana Senior Nursing Educator - Remote OH, IN, KY in Louisville Kentucky Description The Senior Nursing Educator plans, directs, coordinates, evaluates, develops, and/or delivers training and education programs for ..
OverviewnThe System Healthcare Analyst, Controlled Substance Accountability: Audit and ... for Controlled Substance Accountability. The analyst will monitor compliance to UofL ... of conduct Complies with HIPAA privacy and security..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Louisville Kentucky Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..
Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Louisville Kentucky Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese and ..
... limited to, health insurance, data privacy/security/use, artificial intelligence, primary care, clinical ... 5 or more years of healthcare policy experience including a track ... research, and resource development supporting..
Job Information Humana Healthcare Lead Product Manager: Hispanic Segment Medicare Advantage in Louisville Kentucky Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Hispanic MA customer use. ..
Job Information Humana Nurse Auditor 2-Remote in KY/IN in Louisville Kentucky Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services ..
OverviewnJOB SUMMARYnUnder the direction of the health care provider, responsible for the delivery of patient care that promotes the safety and wellbeing of all patients. Accurately preforms preliminary physical tests. Under ..
Job Information Humana Senior Process Improvement Professional - Remote OH, IN, KY in Louisville Kentucky Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and ..
Description Responsibilities The Business Support Coordinator 1 performs medical record content analysis to ensure compliance with requirements of the TRICARE contract. Prepare, scan, and stage for final distribution all medical records ..