Healthcare Insurance Specialist Jobs

Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and ..

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 ..

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

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

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 Genetic Counselor (Board Certified)-Remote/Virtual in US in Dover Delaware Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..

Job Information Humana Medical Director - S. Florida in Dover Delaware Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

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

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

Job Information Humana Clinical Pharmacy Lead, Remote in Dover Delaware Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..

Location: Dover, DE Department: ABA Services Posted: 05/25/2023 Location Name: Delaware Wage: TBD Come join a team of passionate therapists providing excellent pediatric therapy to children throughout the United States! Achieve ..

... 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..

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 ..

... 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..

... 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..

Location: Dover, DE Department: ABA Services Posted: 05/25/2023 Location Name: Delaware Wage: TBD Shift: 9:00am-5:30pm Monday Through Friday Some Weekends Come join a team of passionate therapists providing excellent pediatric therapy ..

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

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 ..

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 ..

... 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..

... Life** As Senior Remote Clinical Specialist reporting into the Remote Service ... have established mandatory requirements for healthcare workers and others working in ... inclusion in the workplace. Various..