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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Job Information Humana Manager, Care Management(Behavioral Health) - Ohio Medicaid in Lima Ohio Description Humana Healthy Horizons in Ohio is seeking Managers of Care Management who will lead our behavioral health ..
Job Information Humana Care Manager, Licensed Behavioral Health Professional or ... Ohio Description The Field Care Manager, Behavioral Health 2 (Care Manager, Behavioral Health) assesses and evaluates ... members. Responsibilities..
Description The Medical Coding Auditor 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 Coding ..
Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..
Job Information Humana Manager, Fraud and Waste-Remote US in Lima Ohio Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
Description Humana Healthy Horizons is seeking a Pre-Authorization Nurse 1 who will review prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forwards requests ..
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). ..
Description Senior Compliance Professional ensures compliance with governmental requirements as they relate to Medicaid State reporting. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis ..
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 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 ..
Job Information Humana RN, Field Care Manager, Maternity, L&D, Mother Baby in Lima Ohio Description Humana Healthy Horizons in Ohio is seeking a RN Field Care Manager 2 with Maternity, L&D, ..
Description Humana Health Horizons in Ohio is seeking Field Care Managers, Behavioral Health 2 who will assess and evaluate member's needs and requirements to achieve and/or maintain optimal wellness state by ..
Job Information Humana Care Manager, Registered Nurse, RN - Maternity, ... Ohio Description The Field Care Manager assesses and evaluates member's needs ... members. Responsibilities The Field Care Manager Nurse..
Description Humana Healthy Horizons is seekign a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The ..
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 ..
Job Information Humana Care Manager, Registered Nurse, RN in Lima ... is seeking a Field Care Manager to assess and evaluate member's ... Company! Responsibilities The Field Care Manager Nurse..
Job Information Humana RN, Field Care Manager 2 - Maternity, L&D, Mother Baby (Ohio Medicaid) in Lima Ohio Description Humana Healthy Horizons in Ohio is seeking a RN Field Care Manager ..
Description Humana Healthy Horizons in Ohio is seeking Managers of Care Management (Physical Health & Behavioral Health) who will lead our physical or behavioral health care management operations and staff to ..
Description The Associate Director, Full Stack Engineering Performs software engineering activities in all layers of the stack, from setting up the database to programming in the back-end and the appearance at ..
Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..
