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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 ..
... in Montpelier Vermont Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..
Description Humana is seeking a Physician Strategy Sr. Professional to join our growing team. The Physician Strategy professional will be responsible for setting and implementing strategy for internal and external physician ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..
Description The Utilization Management Nurse 1 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 1 work assignments ..
Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..
Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST states Responsibilities The Bilingual Grievances ..
Description The Senior Compensation Professional develops, implements, and administers compensation programs. The Senior Compensation Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Director, Pharmacy Clinical Pipeline oversees the medical and pharmacy drug pipeline tracking and forecasting, supports financial sales analysis and market event news. This position will work and collaborate with ..
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 ..
Job Information Humana Corporate Strategy Consultant in Montpelier Vermont Description Humana's Corporate Stragtegy team is a high-performing organization that works closely with Humana's senior leaders to help chart the course for ..
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health ..
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services. Enjoy the flexibility ..
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 ..
Job Information Humana Bilingual Quality Auditor in Montpelier Vermont Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..
Job Information Humana Senior Innovation Portfolio Strategy Professional in Montpelier Vermont Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives that ..
Description This is a dynamic role where you will work on some of the latest applications of data science to business. You will directly work with key client stakeholders to define ..
Description If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver exceptional ..
Description The Remote Systems Clinical Pharmacist will provide excellent customer service to both internal and external customers by developing and maintaining relationships with Account / Clinical Management and PCO-IPU Operations teams. ..
Description Humana is a Fortune 60 market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and well-being of the ..
Job Information Humana Senior Sales Enablement Product Marketer in Montpelier Vermont Description Humana's Primary Care Organization (PCO) is looking for an experienced and passionate Product Marketer who is hyper customer focused ..
Job Information Humana Senior Copy Writer in Montpelier Vermont 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 ..
