Healthcare Quality Analyst Jobs in Riverton

Description The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..

Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..

Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..

Description Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..

Job Information Humana Senior Innovation Portfolio Strategy Professional in Riverton Wyoming Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that ..

... 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,..

Job Information Humana Quality Improvement Program Lead (National Medicaid ... Improvement Program Lead (National Medicaid Quality) in Riverton Wyoming Description Humana ... Healthy Horizons is seeking a Quality Improvement Program..

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 Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..

Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..

Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..

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 ..

... 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..

... 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..

... 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..

... 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 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 ..

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 ..

... the development and implementation of quality improvement interventions and audits and ... years of experience in Accreditation, Quality Management, Compliance, Utilization Management, Behavioral ... degree Advanced degree in a..

... Humana Nationwide Medicaid Behavioral Health Quality Lead in Riverton Wyoming Description ... Wyoming Description The Behavioral Health Quality Lead will report directly to ... directly to the National Medicaid..

Job Information Humana Director, Informatics in Riverton Wyoming Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..

Job Information Humana Senior Copy Writer in Riverton Wyoming 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 ..

... 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..