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Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
Description The Director, QOCA Strategy - serves as the strategic leader in resource utilization; budget and MER oversight; vendor oversight; and for clinician and non-clinician flex associates and off-shore vendor associates ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Bridgeport Connecticut Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end ..
Qualifications nn n Basic Requirements:nntUnited States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.ntEnglish Language Proficiency. In accordance ..
Job Information Humana Technical Product Manager - Remote in Bridgeport Connecticut ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
Job Information Humana Bilingual Quality Auditor in Bridgeport Connecticut Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
... leader in medical technology and healthcare solutions were a market leader ... success. Together, we can transform healthcare. Join us for a career ... a medical device company or..
Job Description Summary: Health is everything. At CVS Health, colleagues are committed to increasing access, lowering costs and improving quality of care. Millions of times a day, we help people on ..
... in Bridgeport Connecticut 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 Manager, Software Engineering codes software applications ... based on business requirements. The Manager, Software Engineering works within specific ... schedules and goals. Responsibilities The Manager, Software Engineering standardizes..
... in Bridgeport Connecticut Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Director of Healthcare Epidemiology Position Summary: The Director ... Position Summary: The Director of Healthcare Epidemiology is an important role ... Duties of the Director of Healthcare Epidemiology may include..
Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Bridgeport Connecticut Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage and ..
Job Information Humana UM Medical Director - Conviva in Bridgeport Connecticut Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
Description The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or ..
... Kindred at Home RN Clinical Manager in Hauppauge New York The ... Hauppauge New York The Clinical Manager coordinates and oversees all direct ... documentation requirements. Responsible for the..
Job Information Humana Associate Director, Site Reliability Engineering in Bridgeport Connecticut Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, Site ..
... & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US ... & Risk Management Quality Audit (QA) Risk Management Professional 2, you ... for executing the Compliance Oversight..
