Clinical Jobs in District Of Columbia

Description The Senior Quality Assurance, Clinical Professional requires being both a ... critical review judgment to make clinical determinations Knowledge of inpatient and ... Must demonstrate working knowledge of clinical..

Description The Lead, Software Quality & Testing ensures that software products meet business standards, functional and non-functional requirements. The Lead, Software Quality & Testing works on problems of diverse scope and ..

Description The Quality Assurance, Clinical Professional 2 consults and collaborates ... and quality. The Quality Assurance, Clinical Professional 2 work assignments are ... you should strongly consider the Clinical Quality..

Job Information Humana DRG Validation Auditor: REMOTE/Work At Home (Anywhere in the US) in Washington District Of Columbia Description The DRG Validation Auditor extracts clinical information from a variety of medical ..

Job Information Humana Senior Network Strategy Professional-- REMOTE/WORK AT HOME (ANYWHERE IN THE US) in Washington District Of Columbia Description The Senior Network Strategy Professional oversees various efforts involving complex data ..

Job Information Humana UM Administration Coordinator 2 - Work at Home Thurs-Mon Schedule) in Washington District Of Columbia Description (Thursday-Monday Schedule) The UM Administration Coordinator 2 contributes to administration of utilization ..

... resources, which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of moderately complex to complex..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Washington District Of Columbia Description Humana is looking for an experienced Healthcare Investigator to join ..

... resources, which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of moderately complex to complex..

Job Information Humana Senior Provider Engagement Professional - Medicaid Prospective Programs Work at Home in Washington District Of Columbia Description The Senior Provider Engagement Professional develops and grows positive, long-term relationships ..

Job Information Humana Credentialing Professional - Work At Home in Washington District Of Columbia Description The Credentialing Professional obtains and reviews documentation to determine status in a health plan. The Credentialing ..

Description Do you enjoy helping those in need? Do you love researching, analyzing medical documents to determine if something was missed? Have you ever considered yourself a detective for medical claims ..

... resources which may include national clinical guidelines, Humana contract language, Humana ... coverage policies and determinations, MCG, clinical reference materials, internal teaching conferences, ... computer-based review of moderately complex..

... resources which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of moderately complex to complex..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work ... Of Columbia Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug ... and medical literature, while providing clinical support for..

Description Lead, Technology Solutions (Clinical UM) The Lead, Technology Solutions ... strategic technology partner for Humana's clinical business areas including Clinical Operations (focusing on Utilization management), ... Operations (focusing on..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Washington District Of Columbia Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews ..

... resources, which may include national clinical guidelines, CMS policies and determinations, ... guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, ... of moderately complex to complex..

Job Information Humana UM Administration Coordinator 2 - Part Time - Work at Home (Friday-Sunday Schedule) in Washington District Of Columbia Description (Friday - Sunday Schedule) The UM Administration Coordinator 2 ..

... part of Humana within the Clinical IT area. We are looking ... test data management program. The Clinical Test Data Quality Lead will ... responsible for modeling the multiple..

... to be part of Humana Clinical technologies team !!! You have ... solutions for Humana Healthcare Services Clinical technology tea. An opportunity to ... opportunity to build and expand..

Job Information Humana UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Washington District Of Columbia Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, ..

Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..