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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
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 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 ..
Job Information Humana Manager, Coding Education - Remote TX ... of the MRA team, the Manager will work closely with market ... Director of Risk Adjustment, the manager can make..
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,..
Job Information Humana Manager, Fraud and Waste-Remote US in ... in Houston Texas Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Job Information Humana Manager, Fraud and Waste-Remote US in ... San Antonio Texas Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
Description Working with provider data provider data, provider directories, and/or contract management How we Value You Benefits starting day 1 of employment Competitive 401k match Generous Paid Time Off accrual Tuition ..
Job Information Humana Manager, Pharmacy and Medical Trend in San Antonio Texas Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and ..
Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. Responsibilities There are 4 shifts available for this role. All ..
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 ..
... KEY ACCOUNTABILITIES Process Improvement and Project Management Contributes to the identification ... projects, key insights, and ensure project milestones and deliverables are implemented ... manner Develops and manages detailed..
Medical Coding Claim Edit and Denial Specialist Job ... immediate need for a full-time Claim Edit and Denial Specialist. Responsibilities ... position is responsible for resolving claim edits and rejections..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in San Antonio Texas Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible for the administration and monitoring of the ..
Job Information Humana Manager, Fraud and Waste-Remote US in ... in Austin Texas Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
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 Manager, Fraud and Waste-Remote US in ... in Dallas Texas Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..
