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Description The Senior Quality Assurance, Clinical Professional requires being both a nurse/RN and a certified Coder nurse as this position will be cross trained to review DRG (Diagnosis Related Group) audits ..
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 Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... factors. Responsibilities The Senior Medicaid Quality Data and Reporting Analyst will be responsible for the..
Description As a Data and Reporting Analyst, you will be responsible for generating reports and regular datasets for the Primary Care Organization (PCO) related to new patient growth. The Data and ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..
... Information Humana Associate Vice President, Quality Improvement for Healthy Horizons in ... in the role of AVP, Quality Improvement for Healthy Horizons. Decisions ... related to accreditation, auditing and..
POSITION FEATURES: *No Sundays, e/o Saturday, limited late shifts (outpatient only) *Tuition reimbursement *Clinical Advancement Program (CAP)- gain knowledge/increase pay *Growth opportunity including geographic movement and niche disciplines *Full benefits package ..
Location: Dover, DE Department: ABA Services Posted: 05/25/2023 Location Name: Delaware Wage: TBD Come join a team of passionate therapists providing excellent pediatric therapy to children throughout the United States! Achieve ..
Description The Associate Director, Clinical Pharmacy 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, ..
Job Information Humana Strategy Advisor, Healthcare Strategy in Dover Delaware Description ... Delaware Description The Strategy Advisory, Healthcare Strategy provides data-based strategic direction ... Responsibilities Humana: A Fortune 100 Healthcare..
Job Information Humana Quality Improvement Program Lead (National Medicaid ... Improvement Program Lead (National Medicaid Quality) in Dover Delaware Description Humana ... Healthy Horizons is seeking a Quality Improvement Program..
Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..
Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - ... Horizons is seeking a Senior Quality Program Delivery Professional who will ... who will manage and support quality improvement..
Job Information Humana Senior Copy Writer in Dover Delaware Description Humana's The Hive is looking for a Senior Copy Writer to join the team! The Hive is Humana's in-house agency, a ..
... Humana Lead Product Manager - Healthcare API in Dover Delaware Description ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
Job Information Humana Senior Innovation Portfolio Strategy Professional in Dover Delaware Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that ..
... Humana Nationwide Medicaid Behavioral Health Quality Lead in Dover Delaware Description ... Delaware Description The Behavioral Health Quality Lead will report directly to ... directly to the National Medicaid..
Location: Dover, DE Department: ABA Services Posted: 05/25/2023 Location Name: Delaware Wage: TBD Shift: 9:00am-5:30pm Monday Through Friday Some Weekends Come join a team of passionate therapists providing excellent pediatric therapy ..
... HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional ... HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional ... guidelines/procedures. Primary responsibilities for the..
Description The Senior Quality Improvement Professional will focus organizational ... improving South Carolina Medicaid clinical quality performance measures to achieve optimal ... to achieve optimal performance and quality for the..
Description The Principal Quality Leader will lead testing and ... Leader will lead testing and quality collaboration between Business and IT, ... tools and assure adherence to quality standards. Serves..
Job Information Humana Healthcare Strategy Consultant in Dover Delaware ... in Dover Delaware Description The Healthcare Strategy Consultant provides data-based strategic ... Responsibilities Humana, a Fortune 60 Healthcare Company Humana..
