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... for a Senior Business Systems Analyst to join working remote anywhere ... US! The Senior Business Systems Analyst performs analysis of business, process ... specifications. The Senior Business Systems..
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Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships ... goals. The Senior Value-Based Programs Analyst works on problems of diverse ... Responsibilities The Senior Value-Based Programs Analyst..
Description The Senior Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... system tools and database or data warehouse queries and scripts. In ... the analysis of..
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 ..
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 ..
... leverages its advanced knowledge of data, modeling, optimization, and tools. Applies ... operates. Understands and analyzes complex data, articulates to various units within ... 2 - 5 years of..
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 ..
... the analysis of situations or data requires an in-depth evaluation of ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting ... in the..
Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
Description The Senior Product Manager conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Senior Value-Based Financial Analyst supports successful value-based provider relationships ... Responsibilities The Senior Value-Based Financial Analyst advises executives to develop functional ... of new value-based models through data..
... 60 market leader in integrated healthcare with a clearly defined purpose ... us redefine the future of healthcare. With a history of transformation ... about solving big problems in..
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 ..
... working with key partners and data analyst(s). Required Qualifications Bachelor's degree or ... to 5 years of technical healthcare experience Exceptional oral and written ... Proven ability to perform..
... forecasts financial, economic, and other data to provide accurate and timely ... the analysis of situations or data requires an in-depth evaluation of ... The Associate Actuary, Analytics/Forecasting 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 Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Description The Clinical Data and Reporting Professional 2 generates ... leadership decision making. The Clinical Data and Reporting Professional 2 also ... Reporting Professional 2 also pulls data out of..
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 ..
... forecasts financial, economic, and other data to provide accurate and timely ... operational decisions. Establishes metrics, provides data analyses, and works directly to ... Responsibilities The Actuary, Analytics/Forecasting ensures..