Government Healthcare Jobs

Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ..

... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... a Bachelor's degree in Business, Healthcare, or related field and/or 8 ... 5 years' experience in the..

Description The Accounting Lead performs general accounting activities, including the preparation, maintenance and reconciliation of ledger accounts and financial statements such as balance sheets, profit-and-loss statements and capital expenditure schedules. Conducts ..

... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..

Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Troy Michigan Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..

Job Information Humana Manager, Utilization Management RN - Remote in Troy Michigan Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical ..

... support advocacy efforts with state government officials and regulators (in partnership ... 5 or more years of healthcare policy experience including a track ... research, and resource development supporting..

Job Information Humana Utilization Management Registered Nurse - Remote in Troy Michigan Description The Utilization Management Nurse utilizes clinical nursing skills to support the coordination, documentation and communication of medical services ..

Job Information Humana Manager, Credentialing in Troy Michigan Description Responsibilities The Manager, Certifications Operations reviews the applicant's education, training, clinical experience, licensure, accreditation, certifications, professional liability insurance, and other TRICARE requirements ..

... is looking for an experienced Healthcare Investigator to join its industry ... areas Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 1 year of..

... experience Bachelor's degree in Business, Healthcare Administration or related field Excellent ... Successfully receive interim approval for government security clearance (eQIP - Electronic ... their home. We are a..

Job Information Humana Senior Technology Implementation Professional (Remote-Nationwide) in Troy Michigan Description The Senior Technology Implementation Professional delivers new technological solutions to meet business needs within a specified scope while aligned ..

... 5 or more years of healthcare policy experience including a track ... research, and resource development supporting healthcare policy and for translating information ... otherwise Direct understanding of how..

Job Information Humana Senior Data Manager - Primary Care Organization in Troy Michigan Description The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. The Senior ..

Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Troy Michigan Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ..

Job Information Humana Director, Informatics in Troy Michigan Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..

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

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

Job Information Humana Data Manager / ETL Developer - Primary Care Organization in Troy Michigan Description The Data Manager 2 supports all aspects of configuration control, data management, and deficiency reporting. ..

Job Information Humana Market Development Advisor - Medicaid Provider Service Operations in Troy Michigan Description The Market Development Advisor - Medicaid Provider Service Operations provides support to assigned health plan and/or ..

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

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