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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 ..
About this job Find your commute About Lyra Lyra is transforming mental health care through technology with a human touch to help people feel emotionally healthy at work and at home. ..
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 Associate Director, Site Reliability Engineering in Dover Delaware Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, Site ..
Job Information Humana Bilingual Quality Auditor in Dover Delaware Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
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 UM Medical Director - Conviva in Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..
Job Information Humana Technical Product Manager - Remote in Dover Delaware ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
Assistant Directo r full-time, available at Girl's Group Home, a 24/7 program for foster care youth. Assistant Director works with supervisors and direct care staff to ensure trauma-informed, quality services are ..
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 ..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Dover Delaware Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage and ..
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 ..
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 Dover Delaware 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 Quality Improvement Program Lead (National Medicaid Quality) in Dover Delaware Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end ..
... in Dover Delaware 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..
