Clinical Jobs in Wisconsin

Description The Senior Stars Improvement, Clinical Professional is responsible for the ... program. The Senior Stars Improvement, Clinical Professional work assignments involve moderately ... Responsibilities The Senior Stars Improvement, Clinical..

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

... 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..

... 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..

u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u003c/strongu003eu003c/pu003enu003cpu003eThe Clinical Supervisor (RN) will oversee a team of 20 to 30 remote Medical Review Nurseu0026nbsp; Analysts (NA) that complete Targeted Probe and Educate (TPE) work for our Medicare ..

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 Green Bay Wisconsin Description The DRG Validation Auditor extracts clinical information from a variety of medical records ..

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

... 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 Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Green Bay Wisconsin Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..

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

Job Information Humana Senior Medical Auditing Professional: REMOTE/WORK AT HOME in Green Bay Wisconsin Description The Senior Medical Coding Professional acts as the team SME (Subject Matter Expert) and provides training, ..

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 ..

... 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 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 Provider Engagement Professional - Medicaid Prospective Programs Work at Home in Green Bay Wisconsin Description The Senior Provider Engagement Professional develops and grows positive, long-term relationships with ..

Job Information Humana UM Administration Coordinator 2 - Part Time - Work at Home (Friday-Sunday Schedule) in Green Bay Wisconsin Description (Friday - Sunday Schedule) The UM Administration Coordinator 2 contributes ..

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

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

... 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 Green Bay Wisconsin Description The UM Administration Coordinator 2 contributes to ..