Manager Healthcare Payer Jobs

Description Be a part of the eBusiness team, drivers of provider self-service adoption through education and promotion of electronic transactions the Availity secure provider portal, Watson Voice, EDI, etc. As a ..

Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..

Description The Manager, Care Management leads teams of nurses and behavior health professionals responsible for care management. The Manager, Care Management works within specific guidelines and procedures; applies advanced technical knowledge ..

Description The Director of Product Management for Clinical Pharmacy Products develops and evaluates new product ideas, enhance existing products or strategic product extensions, and translates research discoveries into marketable products. This ..

Job Information Humana Manager, Utilization Management RN - Remote ... in Dover Delaware Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management..

Description As the Associate Director, Provider Contracting for the Mid-Atlantic region, you will lead a team of 4 associates with an enterprise mindset, continually build cultural competency, think strategically, and collaborate ..

... acumen to solve for the healthcare challenges of today. The Clinical ... anywhere The Clinical Trend Program Manager (PM) role designs, communicates, and ... years or more working in..

Description Humana Medicaid is growing and you have the unique opportunity to grow with us! Join our team and propel Humana forward to solve the technology challenges of tomorrow. You'll collaborate ..

... (CCM) organization is seeking a Manager, Fraud & Waste to join ... As the Fraud & Waste Manager at Humana, you will support ... that our members receive quality..

... realization of high-quality and cost-effective healthcare.Foster continuous improvement of nursing services ... families' needs and expectations.Why Genesis?Genesis HealthCare is a leading provider of ... is a leading provider of..

Description The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder ..

Description The Associate Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..

... preference with judicious use of healthcare resources Educates physicians regarding InterQual ... for high-risk patients across the healthcare continuum. Ensures the delivery of ... is a national leader in..

Job Information Humana Lead Product Manager - Healthcare API in Dover Delaware Description ... Delaware Description The Lead Product Manager - Healthcare API (SME) as part of ... Individual will..

... Clinical Analytics and Trend Program Manager in Dover Delaware Description The ... Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... Minimum 2 years working in..

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..

Job Information Humana Manager, Fraud and Waste-Remote US in ... in Dover Delaware Description The Manager, Fraud and Waste conducts investigations ... fraudulent and abusive practices. The Manager, Fraud and..

Description The Manager, Medical Coding oversees the coding team that is reviewing inpatient records for appropriate coding to include ICD-10, CPT, and HCPCS. The Manager, Medical Coding works within specific guidelines ..

Job Information Humana Oncology Market Director in Dover Delaware Description The Market Director, Oncology leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions to Humana ..

Job Information Humana Product Manager Lead, Pharmacy Transformative Products Team, ... 60 market leader in integrated healthcare with a clearly defined purpose ... us redefine the future of healthcare. With..

Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in Dover Delaware Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication ..

Description Responsibilities The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that ..

Description The Manager, STARS Improvement develops, implements, and manages oversight of the company's Medicare Stars Program. This position will manage the Stars improvement team. Responsibilities The Manager, STARS Improvement develops the ..