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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 ... Pittsburgh Pennsylvania Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
Job Information Humana Care Manager, Telephonic Nurse 2 - WAH ... Pittsburgh Pennsylvania Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
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 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 ..
We have an immediate opportunity for an Director of Admissions General Summary: The Director of Admissions is responsible for the hospital’s overall admission process and staff. The Director of Admissions is ..
We have an immediate opportunity for Admissions Representatives General Summary: The Admissions Representative serves as the coordination point for referring facilities, physicians, payors and families by coordinating all aspects of referral/admission ..
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 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 ..
Job Information Humana Technical Product Manager - Remote in Pittsburgh Pennsylvania ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
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 ..
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 ..
Job Information Humana Telephonic Behavioral Health Care Manager in Pittsburgh Pennsylvania Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or ..
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 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 ..
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 ..
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,..
... in Pittsburgh Pennsylvania Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
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..
... Responsibilities The Telephonic Nurse Case Manager will be a member of ... continuum of care. The case manager will offer guidance. support, and ... or other members of the..
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..