Specialist Jobs

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 Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..

Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Dover Delaware Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..

Location: Dover, DE Department: ABA Services Posted: 05/25/2023 Location Name: Delaware Wage: TBD Come join a team of passionate therapists providing excellent pediatric therapy to children throughout the United States! Achieve ..

The City of Dover Fire & Rescue is accepting applications for the positions of fulltime Firefighter/EMT, as well as to produce an eligibility list for anticipated vacancies. Salary Range: $23.48 to ..

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

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 UM Medical Director - Conviva in Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

Remote Inpatient Coding Opportunity – Full-time/Director Hire   Requirements:  3+ years of Inpatient Coding, Auditing experience preferred   Credentials:  CCS, RHIT, or RHIA Required   Reviews and evaluates hospital inpatient medical record documentation to ..

**Careers that Change Lives** Interested in a remote clinical sales role with flexible working arrangement? We have an unique opportunity for an experienced and motivated clinical sales professional to join our ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Dover Delaware Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Dover Delaware Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing clinical ..

Job Information Humana Medicare Appeals and Grievance Medical Director in Dover Delaware Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

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

Job Information Humana Clinical Pharmacy Lead, Remote in Dover Delaware Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..

Job Information Humana Medical Director - S. Florida in Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

Job Information Humana Medical Director - Florida Medicaid in Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..

Location: Dover, DE Department: ABA Services Posted: 05/25/2023 Location Name: Delaware Wage: TBD Shift: 9:00am-5:30pm Monday Through Friday Some Weekends Come join a team of passionate therapists providing excellent pediatric therapy ..

Job Information Humana Medical Director - National Medicare Team in Dover Delaware Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments ..

Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Dover Delaware Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and scope ..

Job Information Humana FP&A Lead, Medicaid Market in Dover Delaware Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..