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Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, ..
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Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 ... verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are ... Where you Come In The..
Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..
Description The Wellness Coach 2 supports health promotion and disease prevention and care management services. The Wellness Coach 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description Come join the Digital Health & Analytics (DH&A) team within Humana to build a world class Data Science and Insights enterprise capability leveraging digital-first platforms, analytics, and agile development methodologies. ..
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 ..
Description The Medical Coding Coordinator 2 extracts clinical ... information from a variety of medical records and assigns appropriate procedural ... assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM,..
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 ..
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 The Senior Physician Recruiter recruits qualified physicians for medical staff and assists in development of strategic physician recruitment plans. The Senior Physician Recruiter work assignments involve moderately complex to complex ..
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 Large Group Medical Underwriter computes rates for both renewing and prospective moderate to complex group accounts. The Large Group Underwriter 2 work assignments are varied and frequently require interpretation ..
Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..
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 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 ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
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 ..
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 ..
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 ..
