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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..
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 ..
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 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 ..
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 ..
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 Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
