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Description The RN, Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The RN ..
Description The Compliance (UM) Professional 2 conducts and summarizes compliance audits. The Compliance (UM) Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses ..
Description The Subrogation Professional 2 iIdentifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health ..
Job Information Humana OB Care Management Support Assistant 2/Medicaid (Bilingual English/Spanish or Creole) Remote FL in Saint Augustine Florida Description The Care Management Support Assistant 2 contributes to administration of care ..
Job Information Humana Medicare Sales (Field) Representative - St. Augustine, FL in Saint Augustine Florida Description Are you passionate about the Medicare population, looking for an opportunity to work in sales, ..
... department prefers candidates that are bilingual in both English and Spanish. ... Spanish. This does not exclude non-bilingual candidates If you are bilingual, you are invited to take .....
Description The Referral Coordinator 1 schedules and pre-registers patients for exams and procedures with specialists and providers outside of the primary care physician's office. The Referral Coordinator 1 performs basic administrative/clerical/operational/customer ..
Job Information Humana Compliance Prof 2/Process and Market Support- Remote in US in Saint Augustine Florida Description Do you crave new challenges and solving problems? Are you looking for an opportunity ..
Job Information Humana Medicare Sales (Field) Representative - Daytona Beach, FL in Palm Coast Florida Description Are you passionate about the Medicare population, looking for an opportunity to work in sales, ..
Job Information Humana Call Quality Coach (Call Quality Professional 2) REMOTE in Saint Augustine Florida Description The Call Quality Coach (Call Quality Professional 2) provides information to assist in the feedback ..
Job Information Humana Medicare Sales Field in Saint Augustine Florida Description Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the ability to ..
Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the ..
Job Information Humana Supervisor, Grievances & Appeals in Saint Augustine Florida Description The Supervisor, Grievances & Appeals works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable ..
Job Information Humana Call Quality Coach in Saint Augustine Florida Description The Call Quality Coach (Call Quality Professional 2) monitors and evaluates the quality of inbound and/or outbound customer service calls. ..
Description The Grievances & Appeals Professional 2 manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Grievances & Appeals ..
Job Information Humana Medicare Sales Field Agent - Saint Augustine in Saint Augustine Florida Description Are you passionate about the Medicare population, looking for an opportunity to work in sales, and ..
Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Job Information Humana Medicare Sales Field Agent in Saint Augustine Florida Description Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the ability ..
Job Information Humana Call Quality Coach (Call Quality Professional 2) in Saint Augustine Florida Description The Call Quality Coach (Call Quality Professional 2) provides information to assist in the feedback and ..
Job Information Conviva Physician - Conviva - Palm Coast in Palm Coast Florida Description Humana's Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care ..
Job Information Humana Care Coach 1 - St Augustine/Palm Coast - FL in Saint Augustine Florida Description The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or ..