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Description The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..
Description The Inbound Contacts Representative 4 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer ..
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 ..
Job Information Humana RN Care Manager--Compact License Required-Spanish Bilingual a plus-WAH Nationwide in Riverton Wyoming Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' ..
Job Information Humana RN Care Manager--Compact License Required-WAH Nationwide in Riverton Wyoming Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs and requirements ..
Job Information Humana RN-Care Manager, Behavioral Health-RN in an eNLC state required in Riverton Wyoming Description The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members' ..
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 Behavioral Health 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 ..
Description Humana Healthy Horizons in Florida is seeking a STARS Improvement Professional 2 who will develop, implement, and manage oversight of the company's Medicaid Stars Program. They will direct all quality ..
Job Information Humana Medicare/Medicaid Program Manager -- Remote in Riverton Wyoming Description Humana's Enterprise Shared Services organization is seeking an outstanding cross-functional program leader to join its Business Management team. This ..
Description The Medical Coding Coordinator 2 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 ..
Description CarePlus is seeking a Nursing Educator 2 who will plan, direct, coordinate, evaluate, develop, and/or deliver training and education programs for professional nursing personnel. The Nursing Educator 2 work assignments ..
Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Riverton Wyoming Description The Medical Coding Auditor reviews medical claims submitted against medical records provided, ..
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 ..
Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members ..
Job Information Humana Bilingual Spanish RN Care Manager--Compact License Required-WAH Nationwide in Riverton Wyoming Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' needs ..
Job Information Humana RN, Senior Stars Improvement, Clinical Professional in Riverton Wyoming Description Humana Healthy Horizons in Florida is seeking a RN, Senior Stars Improvement, Clinical Professional who will be responsible ..
Job Information Humana Telephonic Care Manager in Riverton Wyoming Description The Telephonic Care Manager will be part of the Humana Military Case Management team; providing a comprehensive, holistic approach for Behavioral ..
Job Information Humana Inpatient Medical Coding Auditor (MSDRG/ APDRG)-Remote/Virtual in US in Riverton Wyoming Description The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate ..
Description The Senior Value-Based Analyst supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Analyst works on problems of diverse ..
Job Information Humana RN Care Manager--Compact License Required-Spanish Bilingual strongly preferred-WAH Nationwide in Riverton Wyoming Description The Care Manager, Telephonic Nurse 2 , in a telephonic environment, assesses and evaluates members' ..
Description The Senior Learning Design Professional uses instructional design, cognitive psychology and adult learning theory to determine the appropriate solution in order to conduct or facilitate training courses for organization employees ..
