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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..
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 ..
... 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..
Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding ..
... 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..
... 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 .....
... Humana Clinical Analytics and Trend Program Manager in Troy Michigan Description The ... The Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... managers across the..
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 ..
... Management Support Professional- Prescription Assistance Program-CenterWell-Remote in Troy Michigan Description The ... complexity. Responsibilities The Prescription Assistance Program Field Care Manager works specifically with both CenterWell ... medications from..
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 ..
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 Behavorial Economics Program Manager - Test & Learn Portfolio ... Michigan Description The Behavioral Economics Program Management Lead designs, executes, and ... large-scale experiments. The Behavioral Economics..
Job Information Humana Senior Project Manager -- Remote in Troy Michigan ... Michigan Description The Senior Project Manager manages all aspects of a ... within budget. The Senior Project Manager..
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 ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Troy Michigan Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..
... 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..
Job Information Humana Care Manager, Telephonic Registered Nurse, (RN) 2 ... Troy Michigan Description The Care Manager, Telephonic Nurse 2 , in ... wellbeing of members. The Care Manager, Telephonic..
... continuum of care with premier healthcare providers, clinicians and patient focused ... of delivering quality & compassionate healthcare within proven care models with ... responsible for overseeing the compliance..
Description The Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
Description Humana Healthy Horizons in Florida is seeking a STARS Improvement Professional 2 who will develop, implement, and manage oversight of the company's Medicaid Stars Program. They will direct all quality ..
Job Information Humana Telephonic Care Manager in Troy Michigan Description The ... Michigan Description The Telephonic Care Manager will be part of the ... coping skills. Responsibilities The Case Manager..
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...
