Healthcare Insurance Specialist Jobs

Description Do you thrive on working on the cutting edge? Working with innovators in the early stages of ideas, products, or platforms? Do you want to transform an industry? Crave new ..

Description Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain ..

Description Job Description Summary Care Management Support Specialists contribute to the administration of care management. The CMSS provides non-clinical support to the assessment and evaluation of members' needs and requirements to ..

... whether services provided by other healthcare professionals are in agreement with ... hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. ... managed Medicaid, or..

... Qualifications Bachelor's degree in nursing, healthcare, or related field Prior experience ... experience in a fast paced insurance or health care setting Knowledge ... 3 years' experience working on..

Job Information Humana Medicare Appeals and Grievance Medical Director in Cincinnati Ohio Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part ..

Job Information Humana FP&A Lead, Medicaid Market in Cincinnati Ohio Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..

CURRENT UC EMPLOYEES MUST APPLY INTERNALLY VIA SUCCESSFACTORS > HTTP://BIT.LY/UCEMPL   Founded in 1819, the University of Cincinnati ranks among the nation's best urban public research universities. Home to more than 47,000 ..

... apply nursing knowledge for evolving healthcare environments. UC Nurses. We See ... and experience working in a healthcare related field. *Knowledge of medical ... and computer hardware/software. *Experience in..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Cincinnati Ohio Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..

... 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..

Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..

... Certified Diabetes Care and Education Specialist-Remote-US in Cincinnati Ohio Description The ... Certified Diabetic Care and Education Specialist (CDCES) delivers comprehensive and seamless ... Certified Diabetes Care and Education..

Description iCare is seeking an Enrollment Specialist who will support the iCare enrollment processing duties for all lines of business including Medicare, Medicaid, Family Care Partnership (FCP) and BadgerCare Plus. Responsibilities ..

Job Information Humana Care Management Supervisor (Prescription Assistance Program)- CenterWell-Remote in Cincinnati Ohio Description The Supervisor, Care Management leads teams of health professionals responsible for assessing and evaluating patient's needs and ..

Job Information Humana Provider Engagement Executive - Behavioral Health in Cincinnati Ohio Description The Behavioral Health Provider Engagement Executive utilizes their knowledge and skills to develop and grow positive, long-term relationships ..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Cincinnati Ohio Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing clinical ..

... looking for an experienced Senior Healthcare Investigator to join its industry ... Qualifications Bachelor's degree or significant healthcare fraud and investigation experience At ... At least 3 years of..

Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Cincinnati Ohio Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and scope ..

Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Cincinnati Ohio Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is responsible ..

Job Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Cincinnati Ohio Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..

... Center is recruiting a Collections Specialist, LPN in the Therapeutic Apheresis ... all our activities. The Collections Specialist, LPN will perform granulocyte, peripheral ... role as described above. *Comprehensive..

... whether services provided by other healthcare professionals are in agreement with ... whether services provided by other healthcare professionals are in agreement with ... hospitals/ Integrated Delivery Systems, health..