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Job Information Humana Medicaid Associate Director, Compliance Nursing in Lancaster ... Lancaster South Carolina Description The Associate Director, Compliance Nursing reviews utilization ... fraud, waste, and abuse. The Associate Director,..
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Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..
Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Job Information Humana Actuary, Risk and Compliance in Lancaster South Carolina Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare ..
Description The Associate Actuary, SPA RX will be mainly responsible for supporting the pricing work related to our standalone Prescription Drug Plans (PDPs). This includes both bid development and reforecasts throughout ..
Description The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for claims reserve valuation, financial forecasting, and strategic and operational decisions within ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..
Description SeniorBridge/Humana is seeking a Care Management Support Assistant. This professional contributes to the successful administration of home care by providing administrative support in new and existing Home Care markets. This ..
Description Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of a ..
Description As the Associate Director, IT Project Management, you will use your background and experience in program management to lead and manage a team of PMO professionals that support the delivery ..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates new product ideas, enhance existing products or strategic product extensions, and translates research discoveries into marketable products. This ..
Description Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Partners in Primary Care, a division of ..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..
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 ..
Description Humana's Claims Cost Management (CCM) organization is seeking a Manager, Fraud & Waste to join the Provider Payment Integrity-Clinical Audit team working remote anywhere in the US. As the Fraud ..
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Job Information Humana Senior Accreditation Professional in Lancaster South Carolina Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance ..
