Research Jobs in Lancaster

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 Senior Claims Research & Resolution Professional manages claims ... the organization. The Senior Claims Research & Resolution Professional work assignments ... Responsibilities Description The Senior Claims Research &..

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 ..

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 ..

Description Humana's Marketing Organization is seeking a Consumer Experience Professional to join the Market Research Loyalty & Advocacy Insights team. This enterprise team focuses on data analysis and generating insights from ..

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 ..

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 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 The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..

Description The Senior Professional, Medicaid Network Strategy will be accountable for supporting the development of Humana Healthy Horizon's (Medicaid) network and provider strategy for its growth markets. This strategist will provide ..

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 ..

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

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 ..

Description The Senior UX Research Professional performs data analysis supporting ... attitudinal data. The Senior UX Research Professional work assignments involve moderately ... factors. Responsibilities The Senior UX Research Professional..

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 Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..

Description The Senior Compliance Professional ensures compliance with governmental requirements, specifically risk adjustment coding and medical record document requirements. This role acts as the second line of defense by providing oversight ..

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

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 ..

... 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..

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

Description Humana is a Fortune 60 market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and well-being of the ..

Description The Senior Coding Educator identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Responsibilities The Senior Coding Educator is responsible for creating and ..