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... of excellence. The position involves travel of more than 60%. Territory ... Key Opinion Leaders (KOLs) and healthcare stakeholders in disease states of ... appropriate) in academic, community and..
Description The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or ..
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Description The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 work assignments are varied and frequently ..
... physicians, physician groups, and integrated healthcare delivery systems throughout the country. ... delivery systems throughout the country. Healthcare isn't just about health anymore. ... of our members, and the..
Description Humana's recently created Clinical Resource Team is looking to grow the team with a Senior Nurse Auditor roles! This is a unique team that's primary role is to quickly jump ..
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 Actuary, Analytics/Forecasting will develop the financial forecast for the dental and vision benefits included within Humana's growing Medicare Advantage business, as well as pricing and oversight of other stand ..
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 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, ..
Description The Senior Clinical Business Professional is a clinical partner to the Commercial Product Strategy team. The Senior Clinical Business Professional work assignments involve moderately complex to complex issues where the ..
Description The Overutilization Review and Monitoring Staff Clinical Pharmacist is a clinical pharmacist that works in Humana's Drug Management Program. This individual conducts case management on at-risk beneficiaries and potential at-risk ..
... leads, fee schedule reimbursement, needed travel for in person dental office ... on continuously improving consumer experiences Travel is required for this role ... per week or as necessary...
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
... degree Advanced degree in a healthcare-related field Knowledge of NCQA accreditation ... & Health Promotion Accreditation, Multicultural Healthcare Distinction, and/or LTSS Distinction Auditing ... at Home Nationwide with limited..
Description The Senior Claims Research & Resolution Professional manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claims issues/complaints within contractual ..
Job Information Humana Medicare Risk Adjustment Representative 3 (Scheduler) in Albany New York Description The Risk Adjustment Representative 3 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that ..
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 Humana's recently created Clinical Resource Team is looking to grow the team with an Inpatient Senior Medical Coding Auditor roles! This is a unique team that's primary role is to ..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
