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 The Risk Adjustment Representative 2 (Medical Record Retrieval Rep) performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments Responsibilities Be a part of ..

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 ..

... 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 FP&A Lead, Medicaid Market in Tulsa Oklahoma Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..

... 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 Medical Director - Medicare Pharmacy Appeals in Tulsa Oklahoma Description The Medical Director relies on clinical background and reviews Medicare drug requests. The Medical director work assignments involve ..

Job Information Humana Behavioral Health Medical Director - Oklahoma Medicaid in Tulsa Oklahoma Description Humana's Oklahoma Medicaid BH Medical Director will oversee our behavioral health (BH) clinical program for Oklahoma Medicaid ..

Description The Medical Record Retrieval Specialist (Risk Adjustment Representative) travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding ..

... looking for a Patient Account Specialist to join their team. They ... for all assigned accounts Resolving insurance billing problems and answering patient ... for delinquent payments from both..

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

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 Clinical Formulary Strategy Pharmacist - Work At Home in Tulsa Oklahoma Description Responsibilities The Clinical Formulary Strategy Pharmacist monitors drug development pipeline, and medical literature, while providing clinical ..

... 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 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 ..

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 ..

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

... 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..

... shifting perceptions of the health insurance industry. We believe our role ... management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc. Internal .....

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

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

... 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 Tulsa Oklahoma Description The Senior Pharmacy Clinical Advisor will be part of an interactive team with broad exposure and scope ..