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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 ..
Develops and implements standard of care relevant to patient services and personnel. Supervises all nursing personnel who deliver direct patient services. Coordinates all patient services. Retains quality personnel through hiring, training ..
... Las Vegas Nevada 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 Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Las Vegas Nevada Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage ..
Company Name: Smith's Food and Drug Position Type: Employee FLSA Status: Non-Exempt Position Summary: Create an outstanding customer experience through exceptional service. Establish and maintain a safe and clean environment that ..
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 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 Quality Improvement Program Lead (National Medicaid Quality) in Las Vegas Nevada Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the ..
... Las Vegas Nevada Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..
Job Information Centerwell RN Clinical Manager Home Health Full Time in ... Las Vegas Nevada The Clinical Manager coordinates and oversees all direct ... documentation requirements. Responsible for the QA/PI..
Job Information Humana UM Medical Director - Conviva in Las Vegas Nevada 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 Las Vegas ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
... & 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 Description:Intermountain Healthcare is a system of 24 ... quality, cost, and innovation, Intermountain Healthcare brings 45 years' experience in ... care more accessible and affordable.Intermountain Healthcare is looking for..
Job Information Humana Associate Director, Site Reliability Engineering in Las Vegas Nevada Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, ..
Job Description Position Summary EMPLOYER PAID PENSION PLAN OF 29.75% OF YOUR ANNUAL SALARY! GENEROUS BENEFITS PACKAGE! **OPEN TO CURRENT UMC EMPLOYEES ONLY** This position is considered AT-WILL and will serve ..
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 Medical Records Retrieval Specialist/ Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid ..
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 ..
... 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..
