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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 ..
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 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 ..
... & 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..
... well-organized, dynamic, highly motivated project manager to help us deliver on ... Anderson and the Sr. Lab Manager, the clinical research project manager will have responsibility for day-to-day .....
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 Quality Improvement Program Lead (National Medicaid Quality) in Boston Massachusetts Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end ..
... Kindred at Home RN Clinical Manager $25,000 Sign on Bonus in ... in Sandwich, MA The Clinical Manager coordinates and oversees all direct ... documentation requirements. Responsible for the..
The Role:Reporting to the Manager/Director of Quality Control, this individual will be responsible for leading the part of Clinical QC Chemistry Operations team. The individual will directly oversee the Chemistry function ..
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..
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 ..
Job Information Humana Technical Product Manager - Remote in Boston Massachusetts ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Boston Massachusetts Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage and ..
We are a new organization that is disrupting the well-worn path that results in unnecessary emergency room visits for urgent and acute care. Join a small team of clinical and business ..
GENERAL OVERVIEW: The primary responsibility of the Access Nurse is to coordinate the customer oriented inpatient access for outside hospital transfers. In collaboration with Access Services; he/she also helps facilitate timely ..
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 Bilingual Quality Auditor in Boston Massachusetts Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
