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... compliance, and quality performance and staffing management. Detailed Responsibilities include: Leads ... Support development of national clinical staffing models and work with Medicaid ... with Medicaid markets to support..
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..
... for Change Orders, for ACD Program Integrity Audit; driving to operational ... team to work with ACD Program Integrity leadership, develop new, or ... leadership, develop new, or change..
Description The Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Lancaster South Carolina Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication ..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - ... to administer the TRICARE health program for military members, retirees and ... through TRICARE and other military healthcare programs...
... your background and experience in program management to lead and manage ... of the segment PMO, ensuring staffing is appropriate to meet program and project needs, mitigating overall .....
... to administer the TRICARE health program for military members, retirees and ... through TRICARE and other military healthcare programs. High-quality service, cost-effective platforms, ... Discharge Call (PDC) Telephonic Care..
Job Information Humana Senior Project Manager -- Remote in Lancaster South ... Carolina Description The Senior Project Manager manages all aspects of a ... within budget. The Senior Project Manager..
... acumen to solve for the healthcare challenges of today. The Clinical ... home anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... team Low Value Care..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... South Carolina Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
... Management Support Professional- Prescription Assistance Program-CenterWell-Remote in Lancaster South Carolina Description ... complexity. Responsibilities The Prescription Assistance Program Field Care Manager works specifically with both CenterWell ... medications from..
Description The Quality Compliance Professional 2 completes annual quality reviews and research. The Quality Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description Healthcare isn't just about health anymore. It is about caring for family, friends, finances, and personal life goals. It's about living life fully. At the Primary Care Organization, a division ..
Job ID 21000MB5Available Openings 1 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..
Job Information Humana Manager of Fraud and Abuse Data ... South Carolina Description Responsibilities The Manager of Fraud and Abuse Data ... correspondence. KEY ACCOUNTABILITIES 30% Manages Program Integrity team..
... supports the Long Term Care program in meeting optimal member outcomes, ... of services provided by other healthcare professionals in compliance with approved ... clinical resource for the LTC..
Job Information Humana Telephonic Care Manager in Lancaster South Carolina Description ... Carolina Description The Telephonic Care Manager will be part of the ... coping skills. Responsibilities The Case Manager..
... Humana Clinical Analytics and Trend Program Manager in Lancaster South Carolina Description ... The Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... managers across the..
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 Details: Occupational health nursing is the specialty practice that delivers health and safety programs and services to workers and worker populations. The practice focuses on promotion and restoration of health, ..
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 ..
