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Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
... Qualifications 2 plus years of healthcare experience Prior experience in Fraud, ... or Master's Degree in Business, Healthcare Administration or related field Managed ... TRICARE or other Federally regulated..
Job Information Humana Senior Contract Tools, Education, Processes Professional - Remote in Dover Delaware Description The Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and protocol, case studies, ..
... 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..
... We are the future of healthcare and our mission is to ... will help members through their healthcare journey, ensuring they get the ... opportunity to help shape the..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
... 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 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 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 ..
... meetings Required Qualifications Experience in healthcare, healthcare investigations, and/or risk management Supervisory ... Master's degree in Law, Business, Healthcare, or related field Extensive knowledge ... be using an exciting..
Job Information Humana Genetic Counselor (Board Certified)-Remote/Virtual in US in Dover Delaware Description Humana is seeking a Board Certified Genetic Counselor to join our Special Investigations Unit - Clinical Review team ..
Job Information Humana FP&A Lead, Medicaid Market in Dover Delaware Description The Financial Planning & Analysis Lead is acritical leadership role with full market financial oversight over the South Carolina Medicaid ..
... major impact on the health technology industry. The Lead Technology Leadership Professional is responsible for ... delivery and performance. The Lead Technology Leadership Professional works on problems ... to..
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 ..
... Life** As Senior Remote Clinical Specialist reporting into the Remote Service ... have established mandatory requirements for healthcare workers and others working in ... willingness to work with new..
Description Risk Adjustment Coders are responsible for reviewing medical records, completing multiple audits, and special projects. Associates in this role work collaboratively with other departments. Responsibilities The Risk Adjustment Coder ensures ..
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 Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in the US) in Dover Delaware Description The Supervisor, Pre-Authorization Nursing will be managing the team that reviews prior authorization ..
Job Information Humana Clinical Pharmacy Lead, Remote in Dover Delaware Description Be a part of an interactive team with broad exposure and scope within Humana. Humana is seeking a positive and ..