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Description The Associate Actuary analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes unit cost metrics, provides competitive data and ..
Description The Provider Insights & Claims Analytics (PICA) team is a blend of technology, data, and consulting professionals leveraging the latest tools and methods to solve complex business problems. In this ..
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This position is responsible for working on the call center team which handles approximately 900 carrier calls a week. The candidate will be speaking with the carriers and/or drivers directly while ..
Description The Senior Business Intelligence Engineer (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer ..
Description The Claims Research & Resolution Representative 2 ... & Resolution Representative 2 manages claims operations that involve customer contact, ... contact, investigation, and settlement of claims for and against..
Description The Actuary role on the Medical Modeling and Specialty Strategies team within Pharmacy Analytics and Consulting (PAC) is an opportunity to provide analytics in support of Humana Pharmacy Solutions infusion ..
Job Information Humana Claims Research & Resolution Representative 2 ... Rogers Arkansas Description The Bilingual Claims Research and Resolution Representative 2 ... for well-being Responsibilities The Bilingual Claims Research &..
SUMMARY: The Senior Specialist Case Manager shall provide case management services for a designated region. The Sr. Specialist Case Manager shall collaborate with and serve as a liaison for key players ..
Description What Humana Offers We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development ..
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 ..
Description The Senior Business Intelligence Analyst (Claims Strategy) solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Analyst ..
SUMMARY: Position is responsible to perform moderately complex work assignments including operations of specialized software systems. This position is responsible for performing a variety of administrative duties including answering a multiple ..
Description The Pharmacy Claims Lead operationalizes and monitors Coordination of Benefits (COB) and subrogation claim processing logic and processes. Exercises independent judgment and decision making on managing staff, complex issues regarding ..
SUMMARY: This position is responsible for working on the call center team which handles approximately 900 carrier calls a week. The candidate will be speaking with the carriers and/or drivers directly ..
Description The Lead Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions. The Lead Data Scientist works on problems ..
Job Overview: A law firm is seeking a skilled plaintiffs attorney to join its personal injury practice in Springdale, AR. The ideal candidate will be bilingual in Spanish, with a preference ..
Description The Senior Claims Research & Resolution Professional manages ... Research & Resolution Professional manages claims operations that involve customer contact, ... contact, investigation, and settlement of claims for and..
... work independently. The Adjuster of Claims is responsible for the investigation ... or denial of workers compensation claims; timely and correctly administer appropriate ... managers; evaluate potential of subrogation..
Description The Bilingual Claims Research and Resolution Representative 2 ... you Come In The Bilingual Claims Research & Resolution Representative 2 ... services in the settlement of claims. Comprised of..
Description The Senior Medical/Financial Risk Evaluation Professional is responsible for supporting the development, implementation and monitoring of medical/financial risk. The Senior Medical/Financial Risk Evaluation Professional work assignments involve moderately complex to ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
