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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, 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 ..
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 ..
... to apply. Purpose and Scope: Healthcare providers (HCPs) depend on the ... keep themselves healthy. The Senior Manager has direct impact on customer ... through engagement with internal colleagues,..
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..
... Kindred at Home RN Clinical Manager in Oak Brook Illinois The ... Oak Brook Illinois The Clinical Manager coordinates and oversees all direct ... documentation requirements. Responsible for the..
Job Information Humana Technical Product Manager - Remote in Chicago Illinois ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
Job Information Humana Bilingual Quality Auditor in Chicago Illinois Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Chicago Illinois Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end ..
... & 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..
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). ..
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 Description The Telepharmacy Technician is responsible for all daily operations of a Telepharmacy Remote Dispensing Pharmacy location, where the Pharmacist oversight occurs from a separate Supervising Pharmacy location. Telepharmacy Technicians ..
Position Overview The Division of Mental Health is seeking to hire a Southern Region Quality Coordinator. The Southern Region Quality Coordinator will perform Continuous Quality Improvement (CQI) Development, project coordination and ..
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 Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Chicago Illinois Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage and ..