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Description Humana is seeking an experienced management professional to lead an interactive team with broad exposure and scope within Humana. This position will work and collaborate with leaders across the Humana ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director of ..
Job Information Humana FP&A Lead, Medicaid Market in Dover Delaware Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..
... We are the future of healthcare and our mission is to ... will help members through their healthcare journey, ensuring they get the ... are: Passionate about transforming our..
Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..
Description The Staff Clinical Pharmacist is an integral part of the Clinical Drug Policy Management team which ensures synchronization of formulary utilization management policies across multiple systems. Humana is seeking a ..
**Careers that Change Lives** Interested in a remote clinical sales role with flexible working arrangement? We have an unique opportunity for an experienced and motivated clinical sales professional to join our ..
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 Medicare Appeals and Grievance Medical Director in Dover Delaware Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..
Description The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of ..
Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health episodic and per diem requests. The Medical Director provides medical interpretation and determinations whether ..
