Healthcare Resource Specialist Jobs

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 Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..

Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Springfield Missouri Description Humana is seeking an experienced management professional to lead an interactive multidisciplinary team that helps translate the clinical ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Springfield Missouri Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..

... Certified Diabetes Care and Education Specialist-Remote-US in Springfield Missouri Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..

Job Information Humana FP&A Lead, Medicaid Market in Springfield Missouri Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..

Job Information Humana Care Management Supervisor (Prescription Assistance Program)- CenterWell-Remote in Springfield Missouri Description The Supervisor, Care Management leads teams of health professionals responsible for assessing and evaluating patient's needs and ..

Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..

Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..

... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..

Job Information Humana Manager, Pharmacy and Medical Trend in Springfield Missouri Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and medical, ..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Springfield Missouri Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing clinical ..

Description The Associate Director, Clinical Pharmacy monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, ..

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 ..

... that patients aren't navigating the healthcare system alone when they leave ... an essential function of this job.,industry:Healthcare,title:GoHealth Advanced Practitioner - Springfield, MO ... & Manager EHR, Client Services..

... leader in medical technology and healthcare solutions.** **Rooted in our long ... years of work experience in healthcare within an EP, Cath Lab ... years of work experience in..

Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..

Job Information Humana UM Medical Director - Conviva in Springfield Missouri Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Springfield Missouri Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..

... that patients aren't navigating the healthcare system alone when they leave ... an essential function of this job.,industry:Healthcare,title:GoHealth Advanced Practitioner - Springfield, MO ... Consultant, Leiomyosarcoma Implementation Consultant, Resources..