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... IT applications architecture solutions to business problems in alignment with the ... of the Medical Records Management system, an enterprise system for requesting, receiving, storing and ... by delivering..
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... technological solutions to meet Medicaid business needs within a specified scope ... developing, guiding, and documenting clinical business system and functional processes, influences system design to optimize support and..
... vendors, as needed. Humana Government Business government contract requires U.S. citizenship ... to support trend opportunities or business needs. Includes documenting and delivering ... of staffing needs, process flow,..
Description The Clinical Recruiter recruits and interviews prospective employees for hourly and salaried positions for our Care Delivery Organization. Humana is seeking a recruiter who is a self-starter, able to work ..
... is look for a Senior Business Systems Analyst to join working remote anywhere ... in the US! The Senior Business Systems Analyst performs analysis of business, process and user..
... course of action. Humana Government Business government contract requires U.S. citizenship ... Qualifications 3 plus years of healthcare fraud investigation experience 2 plus ... knowledge and experience Experience in..
... Medicaid Quality Data and Reporting Analyst generates ad hoc reports and ... report information for end-users using system tools and database or data ... Medicaid Quality Data and Reporting..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Medical Coding Auditor Supervisor handles a combination of tasks, including extracting clinical information from a variety of medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, ..
Job Information Humana Sr. Clinical Recruiter - VSP( Variable Staffing Pool) in Lancaster South Carolina Description The Senior Recruiter interviews prospective employees for hourly and salaried positions. Assists with university graduate ..
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 ..
... criteria in the Formulary Enterprise System Evaluates new medications and accurately ... Collaborates with other pharmacists and healthcare professionals in a team environment ... Manages and communicates line 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 Healthcare is rapidly changing, and our ... able to work closely with business leaders in Care Management to ... outcome metrics aligned to driving business and strategic goals of..
... and executing on Humana's consumer-focused business strategy demands constant negotiation with ... and documentation within a tracking system. May assist with identifying and ... to ensure effective and efficient..
Description Responsibilities The Quality Improvement Lead provides strategic leadership for Humana's South Carolina Medicaid Quality Program, in alignment with organizational quality and population health goals and ensuring compliance with all contract, ..
... as a focus on collaborative business relationships, value based care, population ... whether services provided by other healthcare professionals are in agreement with ... Delivery Systems, health insurance, other..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
