Healthcare Sourcing Jobs in Charleston

Job Information Humana Senior FP&A Analyst in Charleston West Virginia Description The Senior Financial Planning and Analysis Professional analyzes and forecasts financial, economic, and other data to provide accurate and timely ..

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 The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization, with a focus on oncology requests. The Oncology ..

Description If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver exceptional ..

Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..

Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. ..

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..

Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. This position is for Enclara Pharmacia, a Humana company. Enclara, ..

Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..

Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..

Job Information Humana Telephonic Behavioral Health Care Manager in Charleston West Virginia Description The Behavioral Health Care Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve ..

Job Information Humana Senior Copy Writer in Charleston West Virginia Description Humana's The Hive is looking for a Senior Copy Writer to join the team! The Hive is Humana's in-house agency, ..

Job Information Humana Home Health Registered Nurse in South Charleston West Virginia Description Responsibilities As a Home Health Registered Nurse , you will: Provide admission, case management, and follow-up skilled nursing ..

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..

Description The Remote Systems Clinical Pharmacist will provide excellent customer service to both internal and external customers by developing and maintaining relationships with Account / Clinical Management and PCO-IPU Operations teams. ..

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 Senior Innovation Portfolio Strategy Professional in Charleston West Virginia Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives ..

This position supports the WV Market. Position HighlightsReports to President and Market LeaderOrganize Genesis sales and marketing resources around market dynamics, referral sources, decision-makers, and influencersProvide hands-on leadership support and supervision ..

Job Information Humana Senior Technical Product Manager in Charleston West Virginia Description The Senior Technical Product Manager (TPM) must be able to lead, plan and track all phases of the product ..

Description Humana is seeking a Physician Strategy Sr. Professional to join our growing team. The Physician Strategy professional will be responsible for setting and implementing strategy for internal and external physician ..

Description This is a dynamic role where you will work on some of the latest applications of data science to business. You will directly work with key client stakeholders to define ..

Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..

Job Information Humana Home Health LPN/LVN in South Charleston West Virginia Description Responsibilities The Home Health Nursing, LPN/LVN enables patients to stay in their homes by providing health and personal services; ..