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Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..
Description The Supervisor, Consultative Pharmacy Technicians certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Supervisor, Consultative Pharmacy Technicians works within thorough, prescribed ..
Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..
Description The Care Delivery Tele Sales Supervisor supports and develops a team of Care Delivery Tele Sales Agents. The Care Delivery Tele Sales Supervisor provides timely and effective support to assist ..
Job Information Centerwell LPN, Home Health Full Time in Maynardville Tennessee As a Home Health LPN , you will: Provide professional nursing services under the direction of a RN in compliance ..
... Information Humana Pre- Authorization Nursing Supervisor-- REMOTE/WORK AT HOME (Anywhere in ... in Brentwood Tennessee Description The Supervisor, Pre-Authorization Nursing will be managing ... to the appropriate stakeholder. The..
Job Information Humana Manager of Fraud and Abuse Data Analytics in Brentwood Tennessee Description Responsibilities The Manager of Fraud and Abuse Data Analytics will be responsible for the supervision of the ..
Description The Supervisor, Care Management Support 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 wellness ..
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 ..
Job Information Humana Senior Technology Implementation Professional (Remote-Nationwide) in Brentwood Tennessee Description The Senior Technology Implementation Professional delivers new technological solutions to meet business needs within a specified scope while aligned ..
Description The Consultative Pharmacy Technician 2 certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Consultative Pharmacy Technician 2 performs varied activities and ..
Description The Supervisor, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Supervisor, Compliance ..
Description The Care Manager, Telephonic Nurse Assistant 2 receives inbound calls from members; calls may include providing reminders of preventive screenings, assists with transferring calls to nurses, and answer general questions ..
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 Care Management Supervisor (Prescription Assistance Program)- CenterWell-Remote in Brentwood Tennessee Description The Supervisor, Care Management leads teams of health professionals responsible for assessing and evaluating patient's needs and ..
Description The Integrated Model for D-SNP team is focused on delivering an integrated member experience through a multidisciplinary team. Focused on the highest risk D-SNP members, this team coordinates both inbound ..
Description The Supervisor, UM Administration contributes to administration of utilization management. The Supervisor, UM Administration works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to ..
Description This position is for Enclara Pharmacia, a Humana company. Enclara, is a wholly owned hospice and palliative care pharmacy business acquired by Humana in 2021. Enclara is the nation's largest ..
Job Information Kindred at Home Physical Therapist Home Health PRN in Jefferson City Tennessee As a Home Health Physical Therapist , you will: Plan and administer prescribed skilled physical therapy treatment ..
Job Information Humana Supervisor, Credentialing in Brentwood Tennessee Description Responsibilities The Supervisor, Credentialing Operations is responsible for supervising activities associated with certification and recertification of providers in the TRICARE East Region. ..
Job Information Humana Director, Informatics in Brentwood Tennessee Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from ..
Job Information Humana Referrals Coordinator 2 in Brentwood Tennessee Description The Referrals Coordinator 2 process referrals from Military Treatment Facilities (MTFs) and civilian providers. The Referrals Coordinator 2 performs varied activities ..