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... and enable scientific exchange with healthcare professionals. Aligns with the WW ... to support these. Ensures timely delivery of resources and training to ... matrix team on planning and..
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... Humana is a Fortune 60 healthcare company with a history of ... developing a robust integrated care delivery model that integrates insurance with ... top place to work in..
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 ..
Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Government. Responsibilities The Telephonic..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ... schedules and goals. Responsibilities The Manager, Utilization Management Nursing..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
Description Responsibilities The Telephonic Care Manager will be part of the ... of the condition/disease. The care manager will assess, plan, coordinate, implement, ... Care Management Team, the care manager..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Jersey City New Jersey Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, ..
... care, and/or requested site of service should be authorized. All work ... inpatient, post-acute care environments, outpatient service requests, ER review, pharmacy review ... whether services provided by other..
Description The Senior Product Manager - Fully Insured supports strategy ... Fully Insured supports strategy development, delivery, and management of the 100 ... business. Responsibilities The Senior Product Manager supports..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, and progressive approaches ... Discharge Call (PDC) Telephonic Care Manager will be part of the ... the beneficiary...
Description The Manager, Care Management leads teams of ... responsible for care management. The Manager, Care Management works within specific ... schedules and goals. Responsibilities The Manager, Care Management oversees..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
