Healthcare Quality Analyst Jobs in Puerto Rico

... monitoring of Health and Wellness quality improvement projects; analyzing and summarizing ... improvement projects; analyzing and summarizing quality data related to Health and ... programs and services; and leading..

Job Information Humana Staff Utilization Management Pharmacist/ Staff RX Clinical Programs /LT (Part Time Contract Position - Pharmacist - Remote, Puerto Rico in San Juan Puerto Rico Description The Staff Utilization ..

Job Information Humana Clinical Pharmacy Lead, Remote in San Juan Puerto Rico Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a ..

Job Information Humana Medical Director - S. Florida in San Juan Puerto Rico Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in San Juan Puerto Rico Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work ..

... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... participating in teams focusing on..

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 ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

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 ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

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 ..

PURPOSE AND SCOPE:The professional registered nurse Inpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

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 ..

... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... participating in teams focusing on..

... Humana members to make informed healthcare decisions. Our key goal is ... help our members obtain high quality, affordable healthcare while keeping our provider networks ... (cost) & Effectiveness..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Description The Clinical Pharmacy Lead for Pharmacy trend will be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual ..

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 ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

... whether services provided by other healthcare professionals are in agreement with ... training in transitions of care, quality assurance, utilization management and care ... focusing on transitions of care,..

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 ..

Job Information Humana Manager, Care Management/HMS (RN FULLY BILINGUAL with supervisory and Clinical exp) San Juan, PR in San Juan Puerto Rico Description The Manager, Care Management leads teams of nurses ..