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Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..
Description The Care Management Support Assistant 3 contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
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 Manager, Fraud and Waste-Remote US in ... Charleston West Virginia Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..
... is looking for an experienced Healthcare Investigator to join its industry ... issues regarding technical approach for project components. Exercises good judgment with ... areas Bachelor's degree or significant..
... looking for an experienced Senior Healthcare Investigator to join its industry ... issues regarding technical approach for project components, and work is performed ... Qualifications Bachelor's degree or significant..
Description The Experience Strategy & Transformation Lead enhances the consumer experience by architecting experiences and building capabilities that will positively impact our customers. The Experience Strategy & Transformation Lead works on ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Charleston West Virginia Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be ..
Description The Manager, Fraud and Waste, Genetic Counseling provides clinical support for investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste, Genetic Counseling works within specific guidelines ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Charleston West Virginia Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication ..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Charleston West Virginia Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible for the administration and monitoring of the ..
Description The Senior Product Manager role is a part of ... customer use. The Senior Product Manager will need to build relationships ... home anywhere The Senior Product Manager ideates,..
Description Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..
Description The Medical Coding Coordinator 3 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 ..
Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. This position is for Enclara Pharmacia, a Humana company. Enclara, ..
