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... management functions including contract analysis, claims administration, insurance transactions, financial analysis ... mitigation, including routine adjudication of claims, and interfaces with the company’s ... as non-routine, large and unusual..
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Description The Associate Director, Data Science is a key leadership role in the AI Integration team, and is responsible to help bring the power of AI and Machine Learning to the ..
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 ..
Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production environment. The Manager, Release Management Engineering works within specific guidelines and procedures; ..
Job Information Humana Manager, Pharmacy and Medical Trend in Anchorage Alaska Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and medical, ..
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 requires ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Anchorage Alaska Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..
Description Humana's Enterprise Clinical Management team needs your clinical, business and analytics acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced scientific techniques, ..
Job Information Humana Associate Director, Provider Data Interoperability in Anchorage Alaska Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient business solutions for quality assurance and ..
Job Information Humana Medicaid Associate Director, Compliance Nursing in Anchorage Alaska Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..
Job Information Humana Manager, Operations, Release and Process in Anchorage Alaska Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production environment. ..
Job Information Humana Medicaid Senior Project Manager (Remote) in Anchorage Alaska Description Humana's Claims Process Organization is looking for a Senior Project Manager to join the Project Management team! As the ..
Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..
Job Information Humana Manager of Release Engineering, Remote in Anchorage Alaska Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production environment. ..
... identify and collect overpayment of claims. Contributes to the investigations of ... systems, and by ensuring correct claims payment. Decisions are typically related ... of work experience related to..
Job Information Humana Associate Director, Retail Claims Technology Solutions in Anchorage Alaska Description The Associate Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. The ..
Job Information Humana Manager, Release Management, Remote in Anchorage Alaska Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production environment. The ..
Description Responsibilities Where you Come In The Manager, Medical/Financial Risk Evaluation identifies, assesses, and mitigates any medical or financial risk that arises from inadequate or failed processes, people, systems, or external ..
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 ..
