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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 ..
... and available resources to promote quality, cost-effective outcomes. Coordinate medical, behavioral ... ACD policy, provide outcome measure data to respective providers; serve as ... ensure care coordination assistance. Ensure..
... Member Plan (EFMP), auditing for quality and clinical compliance, and case ... entry and review of CDRL data pertaining to the ACD. Review ... pertaining to the ACD. Review..
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..
... ensuring operationalization of key growth, quality and efficiency strategies. This includes ... Public Health Administration, Public Policy, Healthcare Economics, Business or related field ... Demonstrated expertise in population health,..
Description The Data and Reporting Professional II generates ... system tools and database or data warehouse queries and scripts. The ... warehouse queries and scripts. The Data and Reporting Professional..
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 ..
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 ..
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 ..
... 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..
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 ..
... 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..
... positively impacting members and caregivers quality of life Responsibilities The Strategy ... The Strategy Advancement Lead provides data-backed strategic direction to identify and ... and care manager experience, clinical..
... public policy positions such as: data; resources; subject matter experts; and ... 5 or more years of healthcare policy experience including a track ... research, and resource development supporting..
... the analysis of situations or data requires an in-depth evaluation of ... closing opportunities. Drives improvement of quality outcomes for providers through in-person, ... coding (i.e. identify deficiencies in..
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 ..
... Member Plan (EFMP), auditing for quality and clinical compliance, and case ... entry and review of CDRL data pertaining to the ACD. Review ... compliance with ACD. Monitor for..