Healthcare Insurance Specialist Jobs

Description CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, ..

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 ..

Job Information Humana Director, Pharmacy Clinical Trend and Pipeline in Jersey City New Jersey Description Humana is seeking an experienced management professional to lead an interactive multidisciplinary team that helps translate ..

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 Medical Director - S. Florida in Jersey City New Jersey Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve ..

Job Information Humana Senior Contract Tools, Education, Processes Professional - Remote in Jersey City New Jersey Description The Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and protocol, ..

... 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..

... 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..

Job Information Humana Strategy Advancement Lead - Humana Care Management in Jersey City New Jersey Description The Strategy Advancement Lead provides data-backed strategic direction to identify and address business issues and ..

... 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 Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Jersey City New Jersey Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews ..

Job Information Humana Medical Director - Medicare Pharmacy Appeals in Jersey City New Jersey Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work ..

Job Information Humana Clinical Formulary Strategy Pharmacist - Work At Home in Jersey City New Jersey Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while ..

... 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..

Job Information Humana Manager, Pharmacy and Medical Trend in Jersey City New Jersey Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy ..

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 ..

... 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..

Job Information Humana Medicare Appeals and Grievance Medical Director in Jersey City New Jersey Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for ..

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

Job Information Humana Senior Clinical Pharmacy Advisor, Clinical Program Innovation in Jersey City New Jersey Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure ..

Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Jersey City New Jersey Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical ..

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

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 ..