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Description The Senior Quality Improvement Professional will focus organizational ... (BH)/Substance Use Disorder (SUD) clinical quality performance measures to achieve optimal ... to achieve optimal performance and quality for the..
Job ID 21000FMNAvailable Openings 2 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
... Member Plan (EFMP), auditing for quality and clinical compliance, and case ... compliance with ACD. Monitor for quality standards, claims accuracy, fraud, and ... Qualifications BCBA (Board Certified Behavior..
... staff meets all productivity and quality standards. This leader must have ... routine audits to ensure successful quality performance outcomes and compliance standards ... the promotion of the multi-disciplinary..
Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..
Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that maximize customer value to create a differentiated value proposition for Humana ..
Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana. Responsibilities ..
... closing opportunities. Drives improvement of quality outcomes for providers through in-person, ... provide guidance to practice). Prepares quality slide and presents quality, UM, and CM slides at ... about..
Job Information Humana Senior Innovation Portfolio Strategy Professional in Charleston West Virginia Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives ..
... 5 or more years of healthcare policy experience including a track ... research, and resource development supporting healthcare policy and for translating information ... the development of innovative, high..
... Humana Nationwide Medicaid Behavioral Health Quality Lead in Charleston West Virginia ... Virginia Description The Behavioral Health Quality Lead will report directly to ... directly to the National Medicaid..
Description The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization, with a focus on oncology requests. The Oncology ..
Job Information Humana Technical Product Manager - Remote in Charleston West Virginia Description The Senior Product Management Professional/Technical Product Manager (TPM) must be able to lead, plan and track all phases ..
... positively impacting members and caregivers quality of life Responsibilities The Strategy ... and care manager experience, clinical quality, Stars program performance and savings ... from across the enterprise (clinical,..
... reducing waste and overuse of healthcare services, while encouraging high value ... Trend (CAT) team needs your healthcare, analytic, and research acumen to ... have the opportunity to support..
Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..
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 Quality Improvement Program Lead (National Medicaid ... Improvement Program Lead (National Medicaid Quality) in Charleston West Virginia Description ... Healthy Horizons is seeking a Quality Improvement Program..
Job Information Humana Senior Copy Writer in Charleston West Virginia Description Humana's The Hive is looking for a Senior Copy Writer to join the team! The Hive is Humana's in-house agency, ..
Job Information Humana Director, Informatics in Charleston West Virginia Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights ..
Job Information Humana Senior Technical Product Manager in Charleston West Virginia Description The Senior Technical Product Manager (TPM) must be able to lead, plan and track all phases of the product ..
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 ..
