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Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on ..
Description Seeking meaningful work? As a Fraud and Waste Manager at Humana, you will come to work every day with the knowledge that your work matters. The ideal candidate is a ..
Description Humana's recently created Clinical Resource Team is looking to ... Do you have a solid clinical background in acute care? Well, ... Auditor opportunity with Humana. Performs clinical audit/validation..
Description The Quality Assurance, Clinical Professional 2 consults and collaborates ... and quality. The Quality Assurance, Clinical Professional 2 work assignments are ... you should strongly consider the Clinical Quality..
Description The UM Administration Coordinator 1 contributes to administration of utilization management. The UM Administration Coordinator 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. Responsibilities The ..
Description The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our ..
Description The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines ..
Description The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities for Humana at Home Clinical Outcomes. The Strategy Advancement Advisor provides business intelligence and ..
