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Description The Lead Medical Director relies on medical background and reviews health claims. The Lead Medical Director requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities The Lead ..
Description Responsibilities The Senior Quality Assurance (Home Health) Clinical Professional consults and collaborates with clinicians/nurses to ensure high accountability of compliance and quality and claims are being reviewed correctly. This position ..
Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team working remote/from home anywhere in the U.S. Responsibilities As a Board Certified ..
Description Responsibilities The SIU and PPI Lab review team is seeking a Medical Coding Auditor with a special set of skills. This person will focus on coding and clinical review of ..
Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..
Job Information Humana Physician - CenterWell - Atlanta, GA - College Park in Green Bay Wisconsin Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for ..
Description The Fraud Investigation Technician 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud Investigation Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. ..
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 Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
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 ..
Intake Specialist (Full Time 1st shift) Location: ... a detail-oriented, customer service-focused Intake Specialist to join our growing team. ... multiple departments. As an Intake Specialist you will: Coordinate the..
... of services provided by other healthcare professionals in compliance with review ... whether services provided by other healthcare professionals are in agreement with ... hospitals/ Integrated Delivery Systems, health..
Enjoy the benefits of providing one on one care in a home setting. No more being pulled in multiple directions at the same time. Be less stressed and more in control ..
Description The Senior Clinical Pharmacy Advisor - Trend, is a dynamic role within Humana. We are seeking a positive and proactive individual to contribute to a high performing team that helps ..
Description Humana has a new Claims Research & Resolution Supervisor opening for those in the Green Bay, WI and Louisville, KY areas. The Supervisor manages claims operations that involve customer contact, ..
Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..
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 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 Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
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 Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and ..
