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... 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..
Job Information Humana Healthcare Services Senior Learning Design Professional-Remote ... variable factors. Responsibilities The HCS (Healthcare Services) Learning and Curriculum Senior ... job as we are a healthcare company committed..
Job Information Humana HCS Compliance & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US in Honolulu Hawaii Description The Risk Management Professional 2 identifies and analyzes potential sources 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 ..
... looking for an experienced Senior Healthcare Investigator to join its industry ... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... Qualifications Bachelor's degree or significant..
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 ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive engages in strategic negotiation and relationship-building with a variety of ..
Job Information Humana FP&A Lead, Medicaid Market in Honolulu Hawaii Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
... Communicate with and provide clear documentation to other departments on issues ... Qualifications Bachelor's degree in a healthcare field or equivalent experience. 5 ... years of experience in managed..
Job Information Humana IAM Senior Data Engineer in Honolulu Hawaii Description The Senior Data Engineer Designs, builds, and maintains data processing architectures and solutions enabling the efficient conversion of structured and ..
Job Information Humana Medical Director - Medicare Pharmacy Appeals in Honolulu Hawaii Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..
Description The Market Development Professional 2 provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Market Development ..
Job Information Humana Senior Data Manager - Primary Care Organization in Honolulu Hawaii Description The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. The Senior ..
Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Honolulu Hawaii Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
... is looking for an experienced Healthcare Investigator to join its industry ... enforcement authorities. Assembles evidence and documentation to support successful adjudication, where ... areas Bachelor's degree or significant..
Job Information Humana Call Center Pharmacy Claims Technician, Remote in Honolulu Hawaii Description The Pharmacy Claims Representative 2 adjudicates pharmacy claims and process pharmacy claims for payment. The Pharmacy Claims Representative ..
POSITION FEATURES:Home dialysis biomedical technician. Must have basic tool and plumbing knowledge.About this role: As a Biomedical Technician with Fresenius Medical Care, you will maintain and repair medical and water treatment ..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
Job Information Humana Nurse Auditor 2/ER - WFH/REMOTE-- Anywhere in the US in Honolulu Hawaii Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Job Information Humana Lead - Technology Solutions Encounters in Honolulu Hawaii Description Humana Medicaid is growing and you have the unique opportunity to grow with us! Join our team and propel ..
