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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 Senior Network Strategy Professional-- REMOTE/WORK AT HOME (ANYWHERE IN THE US) in Jersey City New Jersey Description The Senior Network Strategy Professional oversees various efforts involving complex data ..
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Job Information Humana UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Jersey City New Jersey Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, ..
... 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..
... 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 Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Jersey City New Jersey Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews ..
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 ..
Job Information Humana Senior Medical Auditing Professional: REMOTE/WORK AT HOME in Jersey City New Jersey Description The Senior Medical Coding Professional acts as the team SME (Subject Matter Expert) and provides ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
... 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..
... 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..
Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Jersey City New Jersey Description Humana is looking for an experienced Healthcare Investigator to join ..
Job Details: Summary:Westchester Medical Center Health Network (WMCHN) is looking for a Board Certified/Eligible to join our growing and innovative department. The candidate would be integral to the further expansion the ..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Jersey City New Jersey Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading ..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work ... New Jersey Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug ... and medical literature, while providing clinical support for..
Job Information Humana UM Administration Coordinator (M-F or Tu-Sa Schedules Available) - REMOTE/WORK AT HOME (Anywhere in the US) in Jersey City New Jersey Description The UM Administration Coordinator 2 contributes ..
Job Information Humana UM Administration Coordinator 2 - Part Time - Work at Home (Friday-Sunday Schedule) in Jersey City New Jersey Description (Friday - Sunday Schedule) The UM Administration Coordinator 2 ..
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 DRG Validation Auditor: REMOTE/Work At Home (Anywhere in the US) in Jersey City New Jersey Description The DRG Validation Auditor extracts clinical information from a variety of medical ..
... 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..