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Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual to contribute to a high performing team that ..
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 ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
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 Clinical Pharmacy Lead for Pharmacy trend will be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and proactive individual ..
... 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 The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
... 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..
Description Responsibilities As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms ..
Job Information Humana Medical Director - Florida Medicaid in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Description The Claims Research & Resolution Professional 2 works with enterprise shares team comprised of calls/claims/contracting and external provider associates researching the resolution to a pending inquiry. Understands department, segment, and ..
Job Information Humana FP&A Lead, Medicaid Market in Green Bay Wisconsin Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina ..
Description Humana's Marketing organization is seeking an experienced Market Research Lead to join the Market Research Department working remote anywhere in the U.S. This is a newly added role that will ..
Job Information Humana Senior Provider Contracting Professional - TRICARE Behavioral Health in Green Bay Wisconsin Description Responsibilities The position will provide corporate support to the Director of Provider Contracting and is ..
Job Information Humana UM Medical Director - Conviva in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Job Information Humana Medical Director - National Medicare Team in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews preauthorization requests for services. The Medical Director work ..
Description The Director, Pharmacy Clinical Formulary and Medical Drug Strategies oversees and drives the pharmacy and medical drug formulary strategies across all lines of business (Medicare, Commercial, Medicaid). This position will ..
Job Information Humana Medical Director - S. Florida in Green Bay Wisconsin Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately ..
Job Information Humana Clinical Pharmacy Lead, Remote in Green Bay Wisconsin Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive ..
