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Description The Referral Coordinator 2 schedules and pre-registers patients for exams and procedures with specialists and providers outside of the primary care physician's office. The Referral Coordinator 2 performs varied activities ..
Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
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 ..
Job Information Humana Senior Contract Tools, Education, Processes Professional - Remote in Portland Maine Description The Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and protocol, case studies, ..
Job Information Humana FP&A Lead, Medicaid Market in Portland Maine Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..
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 ..
Job Information Humana Clinical Pharmacy Lead, Remote in Portland Maine Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..
... 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..
... Qualifications 2 plus years of healthcare experience Prior experience in Fraud, ... or Master's Degree in Business, Healthcare Administration or related field Managed ... TRICARE or other Federally regulated..
... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Portland Maine Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
... We are the future of healthcare and our mission is to ... will help members through their healthcare journey, ensuring they get the ... opportunity to help shape the..
Job Information Humana Actuary, Risk and Compliance in Portland Maine Description This Actuary role is a newly created role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Portland Maine Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..
Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
