Research Jobs in Charleston

Description The Senior Portfolio Management Professional collaborates with the business portfolio team to align the IT portfolio and demand. The Senior Portfolio Management Professional work assignments involve moderately complex to complex ..

Description The Strategy Advancement Advisor provides strategic direction to drive appropriate care, with the aim of reducing waste and overuse of healthcare services, while encouraging high value care. The team uses ..

Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Charleston West Virginia Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..

Description The CCM Compliance Professional 2 ensures compliance with governmental and contractual requirements. The CCM Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the ..

Job Information Humana Senior Innovation Portfolio Strategy Professional in Charleston West Virginia Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives ..

Description The 'voice of the provider' is key to Humana's integrated care delivery strategy. As Humana evolves from being recognized as a traditional payer to a health care company with deep ..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Charleston West Virginia Description Humana is looking for an experienced Healthcare Investigator to join its ..

Job Information Humana Technical Product Manager - Remote in Charleston West Virginia Description The Senior Product Management Professional/Technical Product Manager (TPM) must be able to lead, plan and track all phases ..

Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..

Description The Lead Cloud Architect leads the planning, design, and engineering of enterprise-level infrastructure and platforms related to cloud computing. The Lead Cloud Architect works on problems of diverse scope and ..

Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..

Job Information Humana Senior Technical Product Manager in Charleston West Virginia Description The Senior Technical Product Manager (TPM) must be able to lead, plan and track all phases of the product ..

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 ..

Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. This position is for Enclara Pharmacia, a Humana company. Enclara, ..

Description The Care Management Support Assistant 2 contributes to administration of Care Management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..

Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..

Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. ..

Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that maximize customer value to create a differentiated value proposition for Humana ..

Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..

... is seeking an experienced Market Research Lead to join the Market ... Lead to join the Market Research Department working remote anywhere in ... membership. Responsibilities As the Market..

Description The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. This position will work and collaborate with ..

Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..

Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..