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Description The Clinical Pharmacy Lead 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, and/or ..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Boston Massachusetts Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
GENERAL OVERVIEW: The primary responsibility of the Access Nurse is to coordinate the customer oriented inpatient access for outside hospital transfers. In collaboration with Access Services; he/she also helps facilitate timely ..
PURPOSE AND SCOPE: The Procurement Analyst uses analytical and quantitative methods to understand, predict, inform, and enhance processes. The analyst will assemble data, analyze performance, identify problems, and develop recommendations. Partners ..
Job Information Humana Care Manager, Telephonic Nurse 2 - WAH ... Boston Massachusetts Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
Description The Manager, Fraud and Waste, Genetic Counseling provides clinical support for investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works within specific guidelines ..
Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness by guiding members/families toward resources appropriate for the ..
Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST states Responsibilities The Bilingual Grievances ..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
... position.PURPOSE AND SCOPE:The Project Financial Manager is responsible for assisting the ... productive working relationships.Escalates issues to supervisor/manager for resolution, as deemed necessary.Review ... interest in ‘the business of..
Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..
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..
Description The Care Manager, Telephonic Nurse Assistant 2 receives ... from members. The NAL Care Manager, Telephonic Nurse Assistant 2 is ... degree in business or related healthcare field Bilingual..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Job Information Kindred at Home RN Clinical Manager $25,000 Sign on Bonus in Boston Massachusetts $25,000 sign-on Bonus Available Position located in Sandwich, MA The Clinical Manager coordinates and oversees all ..
... in Boston Massachusetts Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Job Information Humana Technical Product Manager - Remote in Boston Massachusetts ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
Description The Manager, STARS Improvement develops, implements, and manages oversight of the company's Medicare Stars Program. This position will manage the Stars improvement team. Responsibilities The Manager, STARS Improvement develops the ..
Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..
Description The Manager, Medical Coding oversees the coding team that is reviewing inpatient records for appropriate coding to include ICD-10, CPT, and HCPCS. The Manager, Medical Coding works within specific guidelines ..
Job Information Humana Telephonic Behavioral Health Care Manager in Boston Massachusetts Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or ..
