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Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
Description Humana's Primary Care Organization (PCO) is looking for an experienced and passionate Senior Product Marketing Professional to join the PCO's Field Marketing team. This is a remote role that will ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
PURPOSE AND SCOPE:The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals’ policies and procedures. Areas of practice are ..
Description The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization, with a focus on oncology requests. The Oncology ..
DescriptionInspire and inform each patient. Allow others to achieve their most important objectives while you achieve yours. Improve their prospects-and the vitality of your career. Connect with your goals and change ..
DescriptionLend direction as well as a caring attitude. Bring a smile and your vital knowledge to everyone every day. Brighten prospects for patients and your career. Connect with your goals and ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
PURPOSE AND SCOPE: Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing Social Work Theory of Human Behavior and accepted methods of ..
Description The Medical Coding Auditor 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 Coding ..
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 Senior Sales Enablement Product Marketer in San Juan Puerto Rico Description Humana's Primary Care Organization (PCO) is looking for an experienced and passionate Product Marketer who is hyper ..
DescriptionLend direction as well as a caring attitude. Bring a smile and your vital knowledge to everyone, every day. Brighten prospects for patients and your career. Connect with your goals and ..
Description The Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional work assignments are ..
Job Information Humana RN Care Manager, Telephonic Nurse (Bilingual) - Puerto Rico in San Juan Puerto Rico Description This is a Work-At-Home position located in Puerto Rico. You must be fully ..
PURPOSE AND SCOPE:Supports the Organization mission, vision, core values and customer service philosophy. Adheres to the Organization Compliance Program, including following all regulatory and Organization policy requirements. Provides direct nursing care ..
PURPOSE AND SCOPE:The professional registered nurse Inpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 ..
Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..
PURPOSE AND SCOPE:Supports the training and education of employees based in company facilities and programs within an assigned geographical area. Delivers standardized, competency based, training and development programs including new employee ..