Clinical Jobs in Rhode Island

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 Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Newport Rhode Island Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior ..

Job Information Humana UM Administration Coordinator 2 - Part Time - Work at Home (Friday-Sunday Schedule) in Newport Rhode Island Description (Friday - Sunday Schedule) The UM Administration Coordinator 2 contributes ..

Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Newport Rhode Island Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..

Job Information Humana Senior Provider Engagement Professional - Medicaid Prospective Programs Work at Home in Newport Rhode Island Description The Senior Provider Engagement Professional develops and grows positive, long-term relationships with ..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Newport Rhode Island Description Humana is looking for an experienced Healthcare Investigator to join its ..

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

Job Information Humana Senior Network Strategy Professional-- REMOTE/WORK AT HOME (ANYWHERE IN THE US) in Newport Rhode Island Description The Senior Network Strategy Professional oversees various efforts involving complex data analysis ..

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 ..

Job Information Humana DRG Validation Auditor: REMOTE/Work At Home (Anywhere in the US) in Newport Rhode Island Description The DRG Validation Auditor extracts clinical information from a variety of medical records ..

Job Description As the Senior Analyst, Process you will be responsible for guiding efforts to ensure reliability across the Clinical & Government Services Operations organization. You will coordinate with business partners ..

... 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..

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 Clinical Formulary Strategy Pharmacist - Work ... Rhode Island Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug ... and medical literature, while providing clinical support for..

Job Information Humana UM Administration Coordinator 2 - Work at Home Thurs-Mon Schedule) in Newport Rhode Island Description (Thursday-Monday Schedule) The UM Administration Coordinator 2 contributes to administration of utilization management. ..

... 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, 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 (M-F or Tu-Sa Schedules Available) - REMOTE/WORK AT HOME (Anywhere in the US) in Newport Rhode Island Description The UM Administration Coordinator 2 contributes to ..

... 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 Senior Medical Auditing Professional: REMOTE/WORK AT HOME in Newport Rhode Island Description The Senior Medical Coding Professional acts as the team SME (Subject Matter Expert) and provides training, ..

... 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..