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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 ..
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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 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 Associate Director, Health Information Management in Ridgeland Mississippi Description The Associate Director, Health Information Management ensures data integrity and quality for our encounter submissions systems. The Associate Director, ..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Job Information Humana Manager, Operations, Release and Process in Ridgeland Mississippi Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production environment. ..
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 ..
... 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, Provider Data Interoperability in Ridgeland Mississippi 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 Senior Project Manager (Remote) in Ridgeland Mississippi Description Humana's Claims Process Organization is looking for a Senior Project Manager to join the Project Management team! As the ..
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 Manager, Release Management, Remote in Ridgeland Mississippi Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production environment. The ..
Job Information Humana Manager of Release Engineering, Remote in Ridgeland Mississippi Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production environment. ..
Job Information Humana Associate VP, Business Transformation and Clinical Innovation in Ridgeland Mississippi Description The AVP, Business Transformation and Clinical Innovation leads the business transformation strategy and execution plans required to ..
Job Information Humana Lead Product Manager - Healthcare API in Ridgeland Mississippi Description The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is directly ..
Job Information Humana Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Ridgeland Mississippi Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience and ..
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 Ridgeland Mississippi Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and medical, ..
Job Information Humana Senior Care Manager, Behavioral Health (BCBA) in Ridgeland Mississippi Description Responsibilities The Senior Care Manager, Behavioral Health (BCBA) is responsible for the administration and monitoring of the Autism ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Ridgeland Mississippi Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..
Job Information Humana Associate Director, Retail Claims Technology Solutions in Ridgeland Mississippi Description The Associate Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. 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 ..
