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... analytical approach. Responsibilities The Supervisor, (Healthcare Call Center) Inbound Contacts addresses ... supervises a group of typically support and technical associates; coordinates and ... Working experience working in a..
Description The Care Management Support Assistant 2 contributes to administration ... of care management. Provides non-clinical support to the assessment and evaluation ... of members. The Care Management Support Assistant..
... advanced and highly specialized administrative/operational/customer support duties that require independent initiative ... initiative and judgment. Responsibilities The Healthcare Call Center Lead role works ... guidance. Working experience in a..
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 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 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 ..
... 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 Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
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 ..
Job ID 21000HLPAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Job Information Humana Actuary, Risk and Compliance in Meridian Idaho Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..
... Manager at Humana, you will support our efforts for ensuring claims ... that our members receive quality healthcare at an affordable price. You ... (RN) license 3 years of..
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 Care Management Support Assistant 3 contributes to administration ... of care management. Provides non-clinical support to the assessment and evaluation ... of members. The Care Management Support Assistant..
Description Responsibilities Humana's Corporate Strategy team is a small, high-performing organization that works closely with Humana's senior leadership to chart the course for the company's future. Within Strategy Operations, you will ..
... facility The Supervisor, Care Management Support will lead a team of ... a team of 16-22 care support professionals and contributes to administration ... of care management. Provides non-clinical..
... facilities, or community groups to support regional market priorities, which may ... or care management. Medical Directors support Humana values, and Humana's Bold ... whether services provided by other..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will ... focus on administrative and customer support assignments. Typical work involves processing ... provider/beneficiary inquiries. The Care Management Support..
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 ..
... moderate to substantial. Responsibilities Humana Healthcare Research (HHR) needs your analytical ... tell a compelling story about healthcare today. Through the design and ... with meaningful real-life insights about..
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. The ..
Job ID 21000HL6Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..