Healthcare Research Jobs in Charleston

Description The Senior Portfolio Management Professional collaborates with the business portfolio team to align the IT portfolio and demand. The Senior Portfolio Management Professional work assignments involve moderately complex to complex ..

... reducing waste and overuse of healthcare services, while encouraging high value ... Trend (CAT) team needs your healthcare, analytic, and research acumen to drive clinical opportunities ... have the..

Description The Healthcare Financial Analyst collects, analyzes, and ... Central Region is seeking a Healthcare Financial Analyst to partner closely ... leadership and external exposure with healthcare providers in OH,..

Description Assist local pharmacies with claims adjudication to support medication access for HC & LTC hospice patients; reconcile historic billing issues. This position is for Enclara Pharmacia, a Humana company. Enclara, ..

Description The Care Management Support Assistant 2 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 ..

... is looking for an experienced Healthcare Investigator to join its industry ... other platform o Performing Investigative research and medical record reviews o ... areas Bachelor's degree or significant..

Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..

Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that maximize customer value to create a differentiated value proposition for Humana ..

Description The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain ..

Job Information Humana Senior Innovation Portfolio Strategy Professional in Charleston West Virginia Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives ..

Description The Lead Cloud Architect leads the planning, design, and engineering of enterprise-level infrastructure and platforms related to cloud computing. The Lead Cloud Architect works on problems of diverse scope and ..

Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Supervisor, Pre-Authorization ..

Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..

... is seeking an experienced Market Research Lead to join the Market ... Lead to join the Market Research Department working remote anywhere in ... membership. Responsibilities As the Market..

Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. ..

... strategic product extensions, and translates research discoveries into usable and marketable ... strategic product extensions and translates research discoveries into concepts to test ... Management experience Specialty Pharmacy experience..

Description The 'voice of the provider' is key to Humana's integrated care delivery strategy. As Humana evolves from being recognized as a traditional payer to a health care company with deep ..

Job Information Humana Technical Product Manager - Remote in Charleston West Virginia Description The Senior Product Management Professional/Technical Product Manager (TPM) must be able to lead, plan and track all phases ..

Description The Director, Clinical Pharmacy Drug Evaluation and Policy Strategies oversees drug class reviews/evaluation, clinical policy strategy development, research, P&T committee oversight, and accreditation. This position will work and collaborate with ..

Description The Medical Coding Coordinator 2 will process and apply the appropriate Code Edit claim payment reductions and denials based on software recommendation. The Medical Coding Coordinator 2 reviews submitted medical ..

Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..

Description The CCM Compliance Professional 2 ensures compliance with governmental and contractual requirements. The CCM Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the ..

Job Information Humana Senior Technical Product Manager in Charleston West Virginia Description The Senior Technical Product Manager (TPM) must be able to lead, plan and track all phases of the product ..