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Description The Mail Operations Pharmacy Technician 2 accurately fills and counts medications. The Mail Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
Description The Mail Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. Responsibilities The Failed Claims Pharmacy Technician 2 ensures ..
Description The Health Information Management Professional 2 ensures data integrity for claims errors. The Health Information Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of ..
Description The Medical Director's primary responsibility is the review of medical authorizations or claims to determine the medical necessity of a given service or level of care. The Medical Director's work ..
Description The Mail Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. Responsibilities The Mail Operations Pharmacy Technician 2 ensures ..
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 Description At CVS Health, we share a clear purpose: helping people on their path to better health. Through our health services, plans, and community pharmacists, we're pioneering a bold new ..
Description The Senior Market Development Professional provides support to assigned health plan(s) relative to Behavioral Health RFPs, product implementations and operational support. The Senior Market Development Professional work assignments involve moderately ..
Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Job Information Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at Home in Phoenix Arizona Description The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business ..
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 ..
Description The Associate Director, Clinical Pharmacy 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, ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Phoenix Arizona Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
Posted: 02-Mar-22 Location: Phoenix, Arizona Salary: Open Categories: Operations Internal Number: R70554 Primary City/State: Phoenix, Arizona Department Name: Legal Svcs-Corp Work Shift: Day Job Category: Legal Here for everyone. At Banner ..
... Humana Lead Product Manager - Healthcare API in Phoenix Arizona Description ... The Lead Product Manager - Healthcare API (SME) as part of ... Individual will be leveraging previous..
Job Information Humana Call Center Pharmacy Claims Technician in Phoenix Arizona Description Job Description Summary The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy ..
... 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..
Job Information Humana Call Center Pharmacy Claims Technician, Remote in Phoenix Arizona Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative ..
Description Manages a team of coding educators and reports to Risk Adjustment Director. Responsible for implementing operational and clinical best practices in the risk adjustment methodology, understanding clinical suspects and appropriate ..
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 ..
