Associate Manager Claims Jobs

Description The Manager, Network Operations maintains provider relations ... management and gathering of provider claims data needed for service operations. ... needed for service operations. The Manager, Network Operations works..

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 ... in Salem Oregon Description The Associate Director, Compliance Nursing reviews utilization ... fraud, waste, and abuse. The Associate Director,..

Job Information Humana UM Medical Director - Conviva in Salem Oregon Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

Job Information Humana Associate Director, Retail Claims Technology Solutions in Salem Oregon ... in Salem Oregon Description The Associate Director, Technology Solutions devises an ... on IT business initiatives. The..

Description The Care Manager, Telephonic Behavioral Health 2 , ... wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work ... of action. Responsibilities The Care Manager, Telephonic Behavioral..

... experienced software application development project manager with a proven track record ... the Software Application Development Project Manager is essential in achieving this ... a Software Application Development Project..

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, ..

Job Information Humana Associate Director of Clinical Audit, Payment ... in Salem Oregon Description The Associate Director of Clinical Audit, Payment ... identify and collect overpayment of claims. They will..

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. ..

Job Information Humana Associate Director, Health Information Management in ... in Salem Oregon Description The Associate Director, Health Information Management ensures ... our encounter submissions systems. The Associate Director, Health..

... Where you Come In The Manager, Medical/Financial Risk Evaluation identifies, assesses, ... Our Fortune 100 Company values associate engagement & your well-being. We ... Experience reading and interpreting medical..

Job Information Humana Nationwide Associate Director, Utilization Management Nursing in ... in Salem Oregon Description The Associate Director, Utilization Management Nursing utilizes ... and/or benefit administration determinations. The Associate Director,..

... Information Humana Medicaid Senior Project Manager (Remote) in Salem Oregon Description ... in Salem Oregon Description Humana's Claims Process Organization is looking for ... looking for a Senior Project..

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 ..

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 ..

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, Provider Data Interoperability in ... Provider Medicaid operational business. The Associate Director, Provider Data Interoperability plans, ... Responsibilities The Provider Data Interoperability Associate Director will..

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 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 ..

Description The Associate Director, Payment Integrity uses technology ... identify and collect overpayment of claims. Contributes to the investigations of ... and our financial recovery. The Associate Director, Payment Integrity..

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 ..