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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
... Kidney Disease (CKD) health care team, the CAP RN 1 participates ... plan as indicated and notifies Team Leader, Charge Nurse, Clinical Manager or ... or collaborates with appropriate..
Description The Physician Performance Insights team's mission is to empower Humana ... Humana members to make informed healthcare decisions. Our key goal is ... members obtain high quality affordable healthcare..
Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
Description The Lead Cloud Architect leads the planning, design, and engineering of enterprise-level infrastructure and platforms related to cloud computing. The Lead Cloud Architect works on problems of diverse scope and ..
Job Information Humana Manager, Fraud and Waste-Remote US in Chase City Virginia Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and ..
... $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an accomplished leader to join our team in the newly-created role..
Description The Medical Coding Coordinator 3 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 ..
Description Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
Job Information Humana Quality Improvement Coordinator in Chase City Virginia Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. ..
... is a Fortune 50 market leader in integrated healthcare delivery. As a company whose ... Humana is seeking an accomplished healthcare leader for the position of Regional ... Extensive..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
... opportunity to build a technology team from the ground-up leading digital ... for one of the leading healthcare organizations. Reporting to Director of ... by delivering personalized, simplified, whole-person..
Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..
Description The Care Management Support Assistant 2 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 ..
