Assoc Mgr Claims Jobs in Los Angeles

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 Reports directly to the Vice President, Medical Management Operations and serves as a member of the HGB Executive Committee. Leads functions related to HGB's Care Management programs to include predictive ..

Job Information Humana Medicaid Associate Director, Compliance Nursing in Torrance California Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Description The National Delegation Oversight and Support (NDOS) Associate Director role within the Value Based Strategies team, will collaborate with our Operational Risk Management, Delegation Compliance, various functional business owners (such ..

Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Torrance California Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience and ..

Job Information Humana Manager, Pharmacy and Medical Trend in Torrance California Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and medical, ..

Description The Managing Clinical Pharmacist within the Pharmacy Claim Audit & Review department monitors drug development pipeline, and medical literature, while providing clinical and audit support for internal stakeholders. Utilizes broad ..

Job Information Humana Medicaid Senior Project Manager (Remote) in Torrance California Description Humana's Claims Process Organization is looking for a Senior Project Manager to join the Project Management team! As the ..

Job Information Humana Associate Director, Health Information Management in Torrance California Description The Associate Director, Health Information Management ensures data integrity and quality for our encounter submissions systems. The Associate Director, ..

Job Information Humana Lead Product Manager - Healthcare API in Torrance California Description The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is directly ..

Job Information Humana Associate Director, Retail Claims Technology Solutions in Torrance California Description The Associate Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. The ..

Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Torrance California Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..

Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Associate Director, Utilization Management Nursing ..

Description Responsibilities The Associate Director for ACD Audit , at the director of the Director of Payment Integrity, will create and implement process improvement plans focused on the beneficiary and provider ..

Job Information Humana Associate Director, Provider Data Interoperability in Torrance California Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient business solutions for quality assurance and ..

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 ..

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 ..

Company: US1113 FreshPoint Southern California, Inc. Zip Code: 91744 Minimum Level of Education: High School or Equivalent Minimum Years of Experience: 4 Years Employment Type: Full Time Travel Percentage: 0 SUMMARY ..

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Job Information Humana Associate VP, Business Transformation and Clinical Innovation in Torrance California Description The AVP, Business Transformation and Clinical Innovation leads the business transformation strategy and execution plans required to ..

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 ..

... 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..

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 ..