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Description The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly ..
Description The Senior Value-Based Programs 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 Analyst works on problems ..
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 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 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 Intern - General 2 performs duties in field of study or profession. The Intern - General 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..
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 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 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 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 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 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 ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Charleston West Virginia Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
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 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 Experience Strategy & Transformation Lead enhances the consumer experience by architecting experiences and building capabilities that will positively impact our customers. The Experience Strategy & Transformation Lead works on ..
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 ..
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, ..
... not limited to: Supports the development and implementation of quality improvement ... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural..
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 ..
