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Description Humana's Claims Cost Management (CCM) organization is seeking a Manager, Fraud & Waste to join the Provider Payment Integrity-Clinical Audit team working remote anywhere in the US. As the..
Description SeniorBridge/Humana is seeking a Care Management Support Assistant. This professional contributes to the successful administration of home care by providing administrative support in new and existing Home Care markets...
Description Responsibilities This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management..
Dear Seniors is hiring for multiple locations. We are interested in Caregivers looking to wok an ongoing position, flexible hours and someone that loves their job!! Now Hiring : Homewood,..
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Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization..
Job Information Humana Senior Accreditation Professional in Birmingham Alabama Description The Senior Accreditation Professional works in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the..
Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs..
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...
Description The Clinical Data and Reporting Professional 2 generates ad hoc reports and regular datasets and reporting for clinical leadership decision making. The Clinical Data and Reporting Professional 2 also..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data..
Right at Home, In-Home Care & Assistance, is seeking to hire a CNA to join a dynamic care team providing clinical expertise in-home. You can make a difference in your..
Description The Actuary, Pricing MA-PD is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates,..
Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice..
Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for..
Description The Care Management Support Assistant 2 (CMSA2) contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or..
