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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 ..
... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... customer service. The Clinical Account Manager (CAM) is directly responsible for ... assigned client(s). The Clinical Account..
Description The Associate Director, Quality Assurance for Humana/Your Home Advantage (YHA) ... programs to establish and maintain quality standards of existing products and ... Wellness Assessments. The Associate Director, Quality..
Description The Manager, Compliance Nursing reviews utilization management ... fraud, waste, and abuse. The Manager, Compliance Nursing works within specific ... schedules and goals. Responsibilities The Manager, Compliance Nursing ensures..
Description The Manager, Quality Improvement implements quality improvement programs for the Kentucky ... line of business. This includes quality compliance and quality improvement activities such as the ... activities such..
... in Cincinnati Ohio Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician..
Description The Associate Director, Quality Improvement implements quality improvement programs for all lines ... annual evaluation. The Associate Director, Quality Improvement requires a solid understanding ... department(s). Responsibilities The Associate..
Description The Associate Director, Utilization Management Nursing uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, ..
Job Information Humana Technical Product Manager - Remote in Cincinnati Ohio ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
Description The Vendor Quality Medical Director will manage clinical ... Director will manage clinical vendor quality outcomes for Humana Clinical Operations ... Director to manage clinical vendor quality outcomes for..
... region, division, and company. Implements quality goals and action plans to ... and action plans to achieve quality standards. Collaborates with operations leaders, ... leadership and patient education and..
Job Information Humana Bilingual Quality Auditor in Cincinnati Ohio Description ... Cincinnati Ohio Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..
Job Information Humana Quality Improvement Program Lead (National Medicaid ... Improvement Program Lead (National Medicaid Quality) in Cincinnati Ohio Description Humana ... Healthy Horizons is seeking a Quality Improvement Program..
Description The Director, Quality Improvement implements quality improvement programs for all lines ... and annual evaluation. The Director, Quality Improvement requires an in-depth understanding ... across departments. Responsibilities The Director,..
... 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 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..
... whether services provided by other healthcare professionals are in agreement with ... training in transitions of care, quality assurance, utilization management and care coordination ... focusing on transitions of..
... in Cincinnati Ohio Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) relies ... guidance to ensure..
Description The Manager, Risk Adjustment oversees coding educators ... Adjustment oversees coding educators and quality assurance audits of medical records and ... and Medicaid Services (CMS). The Manager, Risk Adjustment..
Job Information Humana Associate Director, Site Reliability Engineering in Cincinnati Ohio Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, Site ..
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..
