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Description The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..
Description The Senior Demand and Portfolio Management Professional collaborates with the business portfolio team to align the IT portfolio and demand. The Senior Demand and Portfolio Management Professional work assignments involve ..
Description Responsibilities The Care Management Support Assistant 3 assists in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism ..
Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..
Description The Health Information Management Professional 2 ensures data integrity for claims errors. The Health Information Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of ..
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 Humana's Service Fund organization is looking for Senior Provider Installation Professional to join the team working from home anywhere in the US. The Senior Provider Installation Professional administers the installation ..
... Review ABA treatment plans for policy compliance. Assist with analysis of ... States with a focus upon policy and utilization management Participate in ... with Clinical Department and Program..
... Qualifications Bachelor's degree in a healthcare field or equivalent experience. 5 ... years of experience in managed healthcare analysis, preferably as a Business ... analysis, preferably as a Business..
... and Behavioral Health Quality. Develop policy and procedure, and define/improve processes ... Qualifications Bachelor's degree in Business, Healthcare, or related field. 5 years ... their home. We are a..
Description The Oncology Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization, with a focus on oncology requests. The Oncology ..
Job Information Humana Senior Copy Writer in Riverton Wyoming Description Humana's The Hive is looking for a Senior Copy Writer to join the team! The Hive is Humana's in-house agency, a ..
... Professional builds templates, standard documentation, policy and protocol, case studies, and ... and ensure any state specific policy is created. Oversees National Network ... Qualifications Bachelor's Degree in Business,..
... Information Humana Director of Public Policy in Riverton Wyoming Description The ... Description The Director of Public Policy role resides in Humana's Corporate ... is charged primarily with public..
Description The Supervisor, Care Management Support contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness ..
... Review ABA treatment plans for policy compliance. Assist with analysis of ... States with a focus upon policy and utilization management. Participate in ... with Clinical Department and Program..
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 ..
Job Information Humana Director, Informatics in Riverton Wyoming Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..
... 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 Senior Data Engineer in Riverton Wyoming Description Responsibilities Senior Data Engineer Job Description Summary The Senior Data Engineer Designs, builds, and maintains data processing architectures and solutions enabling ..
Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
... at the national level. Develops policy and procedure, and defines/improves processes ... 3 years of experience managing Healthcare Quality programs OR 8 years ... their home. We are a..
Description The Senior Market Development Professional provides support to assigned health plan(s) relative to Behavioral Health RFPs, product implementations and operational support. The Senior Market Development Professional work assignments involve moderately ..
