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Description The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..
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Description The Inbound Contacts Representative 4 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer ..
Description The Senior Demand and Portfolio Management Professional collaborates with the business portfolio team to align the IT portfolio and demand. The Senior Demand and Portfolio Management Professional work assignments involve ..
Description Humana is looking for an experienced Counselor that truly enjoys helping those in need within a call center environment. Our Counselor's provide ongoing and crisis intervention counseling focused on the ..
Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward ..
Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Professional works on problems ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Riverton Wyoming Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description Humana's recently created Clinical Resource Team is looking to grow the team with an Inpatient Senior Medical Coding Auditor roles! This is a unique team that's primary role is to ..
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 ..
... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural Healthcare Distinction, and/or LTSS Distinction Auditing ... job as we are a..
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 Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
Description The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
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 ..
