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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 ..
... Behavioral Health Director, Quality Improvement Manager and those targeting specialized behavioral ... Qualifications Bachelor's degree in Business, Healthcare, or related field Certified Professional ... related field Certified Professional in..
... data, analytics, user testing, and research. Translate these findings into opportunity ... 8 or more years of project leadership experience Experience leading large ... oriented with excellent organizational and..
Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..
Job Information Humana Technical Product Manager - Remote in Charleston West ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..
Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..
Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..
Description Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..
Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
... Information Humana Senior Technical Product Manager in Charleston West Virginia Description ... Description The Senior Technical Product Manager (TPM) must be able to ... dependencies. The Senior Technical Product..
Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... issues regarding technical approach for project components, and work is performed ... other platform o Performing Investigative..
Description The 'voice of the provider' is key to Humana's integrated care delivery strategy. As Humana evolves from being recognized as a traditional payer to a health care company with deep ..
... is looking for an experienced Healthcare Investigator to join its industry ... issues regarding technical approach for project components. Exercises good judgment with ... other platform o Performing Investigative..
... We deliver value through detailed research, data-driven insights, strategic planning, structured ... planning, structured problem solving, and project management rigor. We are a ... solutions. Creative - Adept at..
... nation's largest full-service pharmacy benefits manager (PBM) specifically for the hospice ... the Pharmacy Claims (Support Services) Manager Assist pharmacies with claims adjudication ... the Pharmacy Claims (Support Services)..
Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that maximize customer value to create a differentiated value proposition for Humana ..
