- Humana (Tallahassee, FL)
- …3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time management ... Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards knowledge is a… more
- Humana (Tallahassee, FL)
- …caring community and help us put health first** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical ... Mandatory overtime during peak season **Job Description:** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional responsible for conducting… more
- Humana (Tallahassee, FL)
- …of our caring community and help us put health first** The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality ... the appropriate ASN to address beneficiary concerns and needs. **The Care Management Support Assistant 3 responsibilities include:** + Assist ASN with care… more
- Ryder System (Tallahassee, FL)
- …._ **Job Description** : **Summary** The Senior Technology Business Management Analyst plays a strategic role in driving financial transparency, ... and partners with senior leadership to shape and execute the Technology Business Management (TBM) strategy. The role requires in-depth expertise in IT financial … more
- Humana (Tallahassee, FL)
- …approximately 40 measures covering preventive care screenings, health condition management , health outcomes, patient experience, and plan operations. Location: ... if in Louisville area then hybrid The HEDIS Condition Management team is seeking a passionate and organized teammate...will be provided a bi-weekly payment for their internet expense . Humana will provide Home or Hybrid Home/Office employees… more
- Humana (Tallahassee, FL)
- …our caring community and help us put health first The Encounter Data Management Professional will conduct research and analysis to execute accurate, timely, and ... completeness of DSNP encounter submissions. Encounter Data Management Professional will have comprehensive knowledge of processes, policies and procedures as well as… more
- Humana (Tallahassee, FL)
- …and help us put health first** The Senior Encounter Data Management Professional develops business processes to ensure successful submission and reconciliation ... in determining objectives and approaches to assignments. The Senior Encounter Data Management professional ensures data integrity for claims errors that result from… more
- Highmark Health (Tallahassee, FL)
- …met. Individual contributor roles as needed. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities including, but not limited to: involved in hiring ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the… more
- Humana (Tallahassee, FL)
- …concrete roadmaps that will generate tangible value to all stakeholders. Within Utilization Management , our goal is to enable members to receive the most appropriate ... + Minimum 2 years of experience with a leading management consulting firm + Strong analytical & strategic skillset...US **Schedule:** M-F 8:00 AM to 5:00 PM Eastern ** Travel :** None **SSN Alert** Humana values personal identity protection.… more
- Humana (Tallahassee, FL)
- …first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied activities and ... will be provided a bi-weekly payment for their internet expense . + Humana will provide Home or Hybrid Home/Office...may be able to research your request quicker. \#LI-LM1 Travel : While this is a remote position, occasional … more