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Humana
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Indianapolis, Indiana
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procedures, explain Humana systems, etc.
Serves as primary relationship manager with LTSS and HCBS ... key operational, clinical, and quality related topics.
**Use your skills to make an impact
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Humana
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Indianapolis, Indiana
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Systems, health insurance, other healthcare providers, clinical group practice management ... national clinical guidelines, CMS policies and determinations, clinical reference materials, internal
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Humana
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Indianapolis, Indiana
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Experience working with EDI (Electronic Data Interchange) systems
Experience building reports (For ... healthcare related data (Insurance, Clinical, Provider, Managed care etc... )
Strong knowledge of SQL
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Humana
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Indianapolis, Indiana
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national clinical guidelines, CMS policies and determinations, clinical reference materials, internal ... Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios
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Humana
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Indianapolis, Indiana
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management and measurement, and/or process-driven systems requirements.
Performs audits focused on improving compliance and quality.
Focus audits - including annual and initial HRA compliance, post
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Humana
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Indianapolis, Indiana
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/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management ... regulatory compliance, and work is assisted by diverse resources, which may include national clinical
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Humana
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Indianapolis, Indiana
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Health Strategy Professional is responsible for improving the quality of care and outcomes while managing ... to achieve desired outcomes.
Quality Improvement:
Collaborate with Quality
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Humana
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Indianapolis, Indiana
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, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over ... as offer personalized clinical and educational services to improve health outcomes and drive superior
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Humana
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Indianapolis, Indiana
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, which may include national clinical guidelines, CMS policies and determinations, clinical reference ... complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, and
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Humana
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Indianapolis, Indiana
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is seeking a Capture Lead, Clinical & Population Health Strategy, to lead initiatives developing and ... horizontally across the organization, coordinating with Medicaid and Medicare leadership and clinical subject
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Humana
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Indianapolis, Indiana
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objectives and approaches to assignments. Assists with quality assurance and user acceptance testing ... is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment
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Humana
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Indianapolis, Indiana
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decisions, utilization management data, and clinical information such as prevention and wellness programs(s ... computer applications/systems
Experience with health promotion, coaching and wellness
Knowledge
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Humana
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Indianapolis, Indiana
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decisions, utilization management data, and clinical information such as prevention and wellness programs(s ... computer applications/systems
Experience with health promotion, coaching and wellness
Knowledge
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Humana
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Indianapolis, Indiana
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which may include national clinical guidelines, CMS policies and determinations, clinical reference ... participate in meetings involving care management, provider relations, quality of care, audit, grievance and
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Humana
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Indianapolis, Indiana
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systems in order to support and improve financial and quality performance within the contracted working ... programs, quality and clinical management, population health, data sharing, connectivity, documentation and
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