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Readmission and ER Visits in VLBW Infants enrolled in a NICU High Risk Follow Up Clinic Objective: To compare rates of readmission and emergency room (ER) visits of very low birth ..
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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..
... 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..
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 UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Bethesda Maryland Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, DME, and ..
... 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..
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 ..
... 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 Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Bethesda Maryland Description Humana is looking for an experienced Healthcare Investigator to join its industry ..
Job Information Humana DRG Validation Auditor: REMOTE/Work At Home (Anywhere in the US) in Bethesda Maryland Description The DRG Validation Auditor extracts clinical information from a variety of medical records and ..
Job Information Humana Senior Medical Auditing Professional: REMOTE/WORK AT HOME in Bethesda Maryland Description The Senior Medical Coding Professional acts as the team SME (Subject Matter Expert) and provides training, guidance, ..
Job Information Humana UM Administration Coordinator 2 - Part Time - Work at Home (Friday-Sunday Schedule) in Bethesda Maryland Description (Friday - Sunday Schedule) The UM Administration Coordinator 2 contributes to ..
Job Information Humana Clinical Formulary Strategy Pharmacist - Work ... Bethesda Maryland Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug ... and medical literature, while providing clinical support for..
Job Information Humana Bilingual / Call Center / Customer Service Rep / Remote / Work from Home / Texas / Virginia / Maryland / North Carolina / South Carolina / Florida ..
Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Bethesda Maryland Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special Investigations ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Bethesda Maryland Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Job Information Humana Senior Provider Engagement Professional - Medicaid Prospective Programs Work at Home in Bethesda Maryland Description The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, ..
... 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 Network Strategy Professional-- REMOTE/WORK AT HOME (ANYWHERE IN THE US) in Bethesda Maryland Description The Senior Network Strategy Professional oversees various efforts involving complex data analysis and ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Job Information Humana UM Administration Coordinator (M-F or Tu-Sa Schedules Available) - REMOTE/WORK AT HOME (Anywhere in the US) in Bethesda Maryland Description The UM Administration Coordinator 2 contributes to administration ..
... 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..