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Description The Care Management Support Assistant 3 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
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... (ECM) team needs your business, healthcare and research acumen to solve ... acumen to solve for the healthcare challenges of today. The Clinical ... and clinical issues using our..
... 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..
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 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 Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
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 ..
... or data requires an in-depth evaluation of variable factors. Responsibilities Assignment: ... and network administration in a healthcare company or healthcare system Medicaid behavioral health contracting ... in the..
Description The Staff Clinical Pharmacist manages the formulary processes for the Clinical Formulary Administration team for the Medicaid LOB. The Staff Clinical Pharmacist work assignments involve moderately complex to complex issues ..
Description The Senior Provider Engagement, Clinical Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the ..
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 Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
Description The Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... or data requires an in-depth evaluation of variable factors. Responsibilities The ... Medicaid Quality Data and Reporting..
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 Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..
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 EAP Senior Counselor, Management Consultant provides ongoing and crisis intervention focused on the emotional, social, vocational, educational, health-related, developmental, and organizational concerns that impact daily lives. The EAP Senior ..
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 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 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 ..
