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Accreditation Lead

Humana
Columbus, OH
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**Become a part of our caring community and help us put health ...
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Summary
About the job:
first**Responsible for leading all NCQA Health Equity Accreditation work for Humana's Medicaid markets. The ideal candidate will have a proven track record of success in accreditation and survey administration, as well as experience in leading teams and providing guidance on complex accreditation questions. They will work closely with cross-functional teams to ensure compliance with NCQA standards, manage team workload and work assignments, and play a key role in NCQA survey administration tasks. This is a dynamic role requiring...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
High school diploma or equivalent
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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Detailed Job Information

Conviva-Primary Care Physician- Winter Haven, FL bilingual Spanish/English

Humana
Winter Haven, FL
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Job Information Position Type: Full Time Certified Age-Friendly Become a ...
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part of our caring community and help us put health first Humana’s Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country in multiple centers across eight states under two brands: CenterWell & Conviva. Operating as a payor-agnostic, wholly owned subsidiary of Humana, our centers put the unique needs of seniors at the center of everything we do. The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a...
Location:
Winter Haven, FL
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Master's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Board Certified
Medical License
Workkeys
Applied Math
6
Graphic Literacy
6
Workplace Documents
6
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Detailed Job Information

Clinical Manager Home Health Full Time

Humana
Winter Haven, FL
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Job Information Position Type: Full Time Certified Age-Friendly Become a ...
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Summary
About the job:
part of our caring community and help us put health first - Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. - Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. - Manages the assignment of caregivers. - Responsible for and oversees the delivery of care to all patients served by the location. Receives case...
Location:
Winter Haven, FL
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Certified Registered Nurse
Driver's License
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Manager, Care Coordination (IN Medicaid)

Humana
Indiana
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Job Information Position Type: Full Time Certified Age-Friendly Become a ...
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About the job:
part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Manager, Care Coordination to lead teams of nurses and behavior health professionals responsible for care management. The Manager, Care Coordination works within specific guidelines and procedures, applies advanced technical knowledge to solve moderately complex problems, receives assignments in the form of objectives, and determines approach, resources, schedules, and goals. The Manager, Care Coordination oversees...
Location:
Indiana
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Associate's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Licensed Clinical Social Worker
Certified Registered Nurse
Driver's License
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

RN Clinical Manager, Home Health

Humana
Avon, IN
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Job Information Position Type: Full Time Certified Age-Friendly Become a ...
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About the job:
part of our caring community and help us put health first The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. - Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. - Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. - Manages the assignment of...
Location:
Avon, IN
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Associate's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Certified Registered Nurse
Driver's License
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

None Specified

Humana
Kissimmee, FL
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RN Clinical Manager Home Health Full Time Become a part of our caring ...
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About the job:
community and help us put health firstTHIS POSITION HAS A $20k SIGN-ON BONUS. The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel.* Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed.* Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies.* Manages the...
Location:
Kissimmee, FL
Job Type:
Part-Time
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Associate's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Driver's License
Certified Registered Nurse
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

RN Clinical Manager, Home Health

Humana
Live Oak, FL
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Become a part of our caring community and help us put health first The ...
Details
Summary
About the job:
Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. - Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. - Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. - Manages the assignment of caregivers. - Responsible for and oversees the delivery of care to all...
Location:
Live Oak, FL
Job Type:
Part-Time
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Associate's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Driver's License
Certified Registered Nurse
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Medical Director - Florida

Humana
Nashville, TN
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Become a part of our caring community and help us put health first The ...
Details
Summary
About the job:
Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and...
Location:
Nashville, TN
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Board Certified
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Compliance Utilization Management RN

Humana
Springfield, IL
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at Humana in Springfield, Illinois, United States Job Description Become a ...
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Summary
About the job:
part of our caring community and help us put health first The Compliance Utilization Management Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The role analyzes report data daily, weekly, monthly, and as needed to assess and identify...
Location:
Springfield, IL
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Associate's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Certified Registered Nurse
National Committee for Quality Assurance
Workkeys
Applied Math
5
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information

Medical Director - Florida

Humana
Albany, NY
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Humana Medical Director - Florida Albany , New York Apply Now Become a part ...
Details
Summary
About the job:
of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be...
Location:
Albany, NY
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
Certifications / Licenses:
Board Certified
Workkeys
Applied Math
4
Graphic Literacy
4
Workplace Documents
5
apply
Detailed Job Information
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