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Job Information Humana Healthcare Lead Product Manager: Chinese and Korean Segment Medicare Advantage in Newport Rhode Island Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Chinese ..
Job Information Humana Healthcare Lead Product Manager: Hispanic Segment Medicare Advantage in Newport Rhode Island Description The Lead Product Manager Conceives of, develops, delivers, and manages products for Hispanic MA customer ..
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 Actuary, Analytics/Forecasting will develop the financial forecast for the dental and vision benefits included within Humana's growing Medicare Advantage business, as well as pricing and oversight of other stand ..
Job Information Humana Actuary, Risk and Compliance in Newport Rhode Island Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
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 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 ..
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 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 Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for claims reserve valuation, financial forecasting, and strategic and operational decisions within ..
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 Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
... major impact on the health technology industry. The Lead Technology Leadership Professional is responsible for ... delivery and performance. The Lead Technology Leadership Professional works on problems ... to..
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 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 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 ..
Team Leader - Tanguay Supervised Apartment Program (Full Time) Location: Woonsocket, RI Tanguay, one of our residential treatment programs is searching for a Team Leader to coordinate program activities, provide supervision ..
Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Newport Rhode Island Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
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 ..
