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Description Humana is seeking a Genetic Counselor to assist in the detecting and investigation of potential fraud and provide clinical guidance to the Special Investigators handling the cases. This is an ..
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Description The Problem, Incident and Event Management Engineer 2 monitors trends in incidents and system issues and helps drive technical support teams to recover services during periods of service disruption or ..
Description The Senior Portfolio Management Professional collaborates with the business portfolio team to align the IT portfolio and demand. The Senior Portfolio Management Professional work assignments involve moderately complex to complex ..
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 ... Qualifications Bachelor's degree in Business, Healthcare,..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..
Description The Director, Strategy Advancement provides data-based strategic direction identifying and delivering new avenues of growth is a critical company priority, championed by the SVP of Retail Strategy & Product. We're ..
Description The Senior Claims Research & Resolution Professional manages claims ... the organization. The Senior Claims Research & Resolution Professional work assignments ... Responsibilities Description The Senior Claims Research &..
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 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 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 ..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, ..
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 ..
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 Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
... (ECM) team needs your business, healthcare and research acumen to solve for the ... acumen to solve for the healthcare challenges of today. The Clinical ... is seeking a..
Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..
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 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 ..
... strategic product extensions, and translates research discoveries into marketable products. This ... insights Bachelor's degree in Business, Healthcare Administration or other related fields ... 50 market leader in integrated..
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 ..
... acumen to solve for the healthcare challenges of today. The Clinical ... low value care and related healthcare resource waste, with a focus ... news and reports in the..