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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 ..
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 ..
Job Information Humana Manager, Operations, Release and Process in Albuquerque New Mexico Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production ..
Job Information Humana Manager, Release Management, Remote in Albuquerque New Mexico Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production environment. ..
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 Medicaid Associate Director, Compliance Nursing in Albuquerque New Mexico Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and ..
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 Lead Product Manager - Healthcare API in Albuquerque New Mexico Description The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is ..
... 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 Albuquerque New Mexico Description Humana's Provider Data and Medicaid Governance team is committed to effective and efficient business solutions for quality assurance ..
Job Information Humana Nationwide Associate Director, Utilization Management Nursing in Albuquerque New Mexico Description The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication ..
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 Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Albuquerque New Mexico Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience ..
Job Information Humana Manager, Pharmacy and Medical Trend in Albuquerque New Mexico Description This leader will oversee a team charged with monitoring, reporting and projecting Humana's drug trends, both pharmacy and ..
Job Information Humana Associate Director, Retail Claims Technology Solutions in Albuquerque New Mexico Description The Associate Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. ..
Job Information Humana Associate Director, Health Information Management in Albuquerque New Mexico Description The Associate Director, Health Information Management ensures data integrity and quality for our encounter submissions systems. The Associate ..
Job Information Humana Medicaid Senior Project Manager (Remote) in Albuquerque New Mexico Description Humana's Claims Process Organization is looking for a Senior Project Manager to join the Project Management team! As ..
Job Information Humana Manager of Release Engineering, Remote in Albuquerque New Mexico Description The Manager, Release Management Engineering manages cross-organizational collaboration required to introduce applications and infrastructure changes into the production ..
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 Associate VP, Business Transformation and Clinical Innovation in Albuquerque New Mexico Description The AVP, Business Transformation and Clinical Innovation leads the business transformation strategy and execution plans required ..
