Assoc Mgr Claims Jobs in Salem

Description The Manager, Network Operations maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. The Manager, Network Operations ..

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 Salem Oregon Description The Associate Director, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations ..

Job Description This recruitment will be used to fill two positions. Our mission... To protect and serve Oregon's consumers and workers while supporting a positive business climate. The Department of Consumer ..

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 Medicaid Senior Project Manager (Remote) in Salem Oregon 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 ..

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 ..

... 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 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 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 Associate Director of Clinical Audit, Payment Integrity - REMOTE in US in Salem Oregon Description The Associate Director of Clinical Audit, Payment Integrity uses their clinical experience and ..

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

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

Description The Senior Product Manager role is a part of the Pharmacy Product & Growth organization and will be responsible for leading initiatives that help drive value for CenterWell Specialty Pharmacy. ..

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

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

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

Job Information Humana Associate Director, Retail Claims Technology Solutions in Salem Oregon Description The Associate Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. 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 Lead Product Manager - Healthcare API in Salem Oregon Description The Lead Product Manager - Healthcare API (SME) as part of Humana's Enterprise API product team, is directly ..