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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Job Information Humana Manager, Pharmacy and Medical Trend in Washington District Of Columbia Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy ..
Description 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 ..
Job Information Humana Medical Director of Trend Analytics in Washington District Of Columbia Description Humana's ECM organization is seeking a Medical Director of Trend Analytics. As a clinical trend leader you ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Washington District Of Columbia Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible for the administration and monitoring of ..
Description The Manager, Fraud and Waste, Genetic Counseling provides clinical support for investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works within specific guidelines ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Washington District Of Columbia Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and ..
Description Job Description Summary 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 ..
Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, ..
Job Information Humana UM Medical Director - Conviva in Washington District Of Columbia Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..
... of services provided by other healthcare professionals in compliance with review ... issues regarding technical approach for project components, and work is performed ... working with health insurance other..
... of services provided by other healthcare professionals in compliance with review ... issues regarding technical approach for project components, and work is performed ... whether services provided by other..
Job Information Humana Manager, Fraud and Waste-Remote US in ... District Of Columbia Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..
Job Information Humana Medical Director - Texas in Washington District Of Columbia Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
