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Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..
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 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 ..
Job Information Humana Associate Director, Site Reliability Engineering in Dover Delaware Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, Site ..
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..
... in Dover Delaware Description The Healthcare Quality Reporting & Improvement (HQRI) organization ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician..
... 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..
... 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..
Job Information Humana Technical Product Manager - Remote in Dover Delaware ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
... in Dover Delaware 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 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..
... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... an account or branch for quality assessment, education and clinical training, ... with the goal of ongoing..
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..
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..
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..
Job Information Humana Bilingual Quality Auditor in Dover Delaware Description ... Dover Delaware Description The Bilingual Quality Auditor/ Professional 2 ensures that ... and Medicare Services standards of quality. Review..
