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Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Dover Delaware Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese and ..
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Description The Principal Quality Leader will lead testing and quality collaboration between Business and IT, guiding test strategies and tools and assure adherence to quality standards. Serves as point of contact ..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Full-time position helping survivors of domestic violence to obtain housing and/or employment. This position requires safety-planning, community advocacy, and accompanying survivors to look at housing prospects. Experience in the field of ..
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 Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also pulls ..
Description The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 work assignments are varied and frequently ..
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 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 The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
Description The Mail Operations Pharmacy Technician 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The associate assists the ADS Implementation & ..
Description Humana's Claims Cost Management (CCM) organization is seeking a Manager, Fraud & Waste to join the Provider Payment Integrity-Clinical Audit team working remote anywhere in the US. As the Fraud ..
... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural Healthcare Distinction, and/or LTSS Distinction Auditing ... job as we are a..
Description SeniorBridge/Humana is seeking a Care Management Support Assistant. This professional contributes to the successful administration of home care by providing administrative support in new and existing Home Care markets. This ..
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 ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates new product ideas, enhance existing products or strategic product extensions, and translates research discoveries into marketable products. This ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The Pharmacy ..
Description The Senior Product Manager conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of ..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..
