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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 Inbound Contacts Representative 4 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer ..
Description The Quality Compliance Professional 2 completes annual ... Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments ... courses of action. Responsibilities..
Description The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. This position will work and collaborate with ..
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 Remote Telephonic RN Opportunity The Compliance Nurse reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Description Full-Time Remote, Telephonic RN opportunity. Humana Care Support is a division of Humana that is dedicated to helping adults remain independent in their homes. Our nurses are titled Care Managers, ..
Job Information Humana CMO - Regional VP, Health Services - Intermountain Region in Riverton Wyoming Description The Regional VP, Health Services relies on medical background and reviews health claims. The Regional ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
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 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 and ..
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 ..
... 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..
... 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..
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 ..
... Program. They will direct all quality improvement programs and initiatives. The ... to implement actions related to quality improvement. They understand department, segment, ... about Medicaid Consumer Assessment of..
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 ..
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 ..
... 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..
American Mobile Healthcare is seeking an experienced Medical ... Job Benefits At American Mobile Healthcare we take care of our ... offer: Competitive pay rates Free, quality, private housing Medical,..
Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members ..
