Manager Healthcare Payer Jobs

... acumen to solve for the healthcare challenges of today. The Clinical ... low value care and related healthcare resource waste, with a focus ... news and reports in the..

... Clinical Analytics and Trend Program Manager in Jersey City New Jersey ... Clinical Analytics & Trend Program Manager role designs, communicates, and implements ... Minimum 2 years working in..

... 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 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 ..

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

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 ..

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). ..

... Training Provided No Dialysis or Healthcare experienced required Full-Time variable schedule ... whole patient. As a case manager, you will also track and ... in-patient treatments in hospital or..

Job Information Humana Senior Sales Enablement Product Marketer in Jersey City New Jersey Description Humana's Primary Care Organization (PCO) is looking for an experienced and passionate Product Marketer who is hyper ..

... Information Humana Behavorial Economics Program Manager - Test & Learn Portfolio ... acumen to solve for the healthcare challenges of today. The Clinical ... years or more working in..

... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..

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 Oncology Market Director in Jersey City New Jersey Description The Market Director, Oncology leverages targeted geographic analysis, engages with Physician offices to influence physicians to route patients' prescriptions ..

Job Information Humana Manager, Utilization Management RN - Remote ... City New Jersey Description The Manager, Utilization Management Nursing utilizes clinical ... and/or benefit administration determinations. The Manager, Utilization Management..

... (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..

Primary Care/Medical Director Opportunities (2) in New Jersey - Next to NYC!!Medical Director positions - Seeking Board Certified Internal Medicine & Family Medicine physicians.Great locations just minutes from downtown NYC.Excellent Schedules, ..

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

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 ..

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 ..

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 ..

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..

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 ..

Job Information Humana Manager, Utilization Management Nursing - Medicare / Medicaid in Jersey City New Jersey Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation ..