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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
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 ..
... of the MRA team, the Manager will work closely with market ... based on advanced knowledge/experience. The Manager, Risk Adjustment works within specific ... approach, resources, schedules and goals.The..
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..
Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Colorado Springs Colorado Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the ..
Description The Senior Pharmacy Sales Executive leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions to Humana Pharmacy for fulfillment. The Senior Pharmacy Sales Executive ..
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 ..
... Colorado Springs Colorado Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Job Information Humana UM Medical Director - Conviva in Colorado Springs Colorado Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Job Information Humana Technical Product Manager - Remote in Colorado Springs ... 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). ..
... Colorado Springs Colorado Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
Description This position is for Enclara Pharmacia, a Humana company. Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the nation's largest ..
... & 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..
Job Information Humana Associate Director, Site Reliability Engineering in Colorado Springs Colorado Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, ..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Colorado Springs Colorado Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage ..
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 ..
