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Description The Payment Integrity Professional 2 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 Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The ..
Description The Medical Coding Auditor reviews medical records to verify coding (ICD-10 CM/PCS). The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate ..
Job Information Humana RN Care Manager--Compact License Required-WAH Nationwide in Honolulu Hawaii Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements ..
Job Information Humana Medical Coding Coordinator 3- Remote USA in Honolulu Hawaii Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural ..
Job Information Humana RN Care Manager--Compact License Required-Spanish Bilingual a plus-WAH Nationwide in Honolulu Hawaii Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Honolulu Hawaii Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
Job Information Humana Bilingual Spanish RN Care Manager--Compact License Required-WAH Nationwide in Honolulu Hawaii Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..
... Humana Senior Process Improvement Professional (HealthCare, Provider Value exp.) Work at ... a Bachelor's degree in Business, Healthcare, or related field and/or 8 ... 5 years' experience in the..
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 Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..
Job Information Humana Outpatient Medical Coding Auditor-Remote/Virtual in US in Honolulu Hawaii Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..
Description The Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate ..
Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..
... 40) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an accomplished healthcare leader for the newly-created role ... quality, appropriate, and cost-effective behavioral..
Job Information Humana Manager, Fraud and Waste-Remote US in Honolulu Hawaii Description The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste ..
Job Information Humana UM Administration Coordinator 2: REMOTE/WORK AT HOME (ANYWHERE IN THE US)) in Honolulu Hawaii Description This UM Administration Coordinator 2 will contribute to administration of pre-certifications, DME, and ..
Job Information Humana Inpatient Medical Coding Auditor-Remote/Virtual in US in Honolulu Hawaii Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology ..
Description Humana is seeking a Physician Strategy Sr. Professional to join our growing team. The Physician Strategy professional will be responsible for setting and implementing strategy for internal and external physician ..
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 ..
Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..
