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Description The Mail Operations Pharmacy Technician 2 accurately fills and counts medications. The Mail Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works ..
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Job Information Humana Medicaid Associate Director, Compliance Nursing in Phoenix Arizona Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
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 The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new ..
Description The SRT Technicians operate as a specialized team within the dispensing facility. Their functionality provides a link between the Front end processing of prescription orders (E-post) and the Back end ..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description Come join the Digital Health & Analytics (DH&A) team within Humana to build a world class Data Science and Insights enterprise capability leveraging digital-first platforms, analytics, and agile development methodologies. ..
Description As Lead Actuary of the Risk Predictive Models team, you have an opportunity to both learn more about predictive analytics and machine learning and to see it become very real ..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Description o Our search is focused on identifying an individual contributor who will take ownership of Medicare risk adjustment programs that fit best with our providers by implementing operational and clinical ..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
u003cpu003eu003cstrongu003eRole Summary: u003c/strongu003eProvide analytical, administrative, and technical assistance in meeting goals of annual Medical Review strategy through development and maintenance of a variety of databasesu003c/pu003enu003cpu003efor monitoring, recording, and reporting purposes. Perform ..
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 Mail Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. Responsibilities The Failed Claims Pharmacy Technician 2 ensures ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Description The Clinical Pharmacy Advisor lead, overseeing Humana Pharmacy and Medical Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high ..
Description This role has responsibility for the oversight and monitoring of the Autism Care Demonstration (ACD) team performance to ensure compliance with contract and complex ACD policy requirements as defined by ..
u003cpu003eu003cstrongu003eRole Summary:u0026nbsp; u0026nbsp;u003c/strongu003eu003c/pu003enu003cpu003eu003cemu003eAre you considering a career move away from direct patient care and want to use your nursing knowledge in a new and different way? If you desire a remote ..
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 ..
