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Job Information Humana Manager, Behavioral Provider Contracting - Remote in Fargo North Dakota Description The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers ..
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Description The Director, 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 Director, Network Operations ..
Description Responsibilities The Telephonic Care Manager will be part of the Humana Military Care Management team; providing a comprehensive, holistic approach for Disease Management and Personal Nurse programs throughout the continuum ..
Description The Medicaid Implementation Senior Project Manager manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Medicaid Implementation Senior ..
Description The Market Development Professional 2 provides support to assigned health plan relative to Medicare/Medicaid product implementation, operations, and contract compliance. The Market Development Professional 2 work assignments are varied and ..
Description Responsibilities Business & Sales Acumen & Management Geography-based; a Regional Sales Director is assigned to each Partner Channel Region. Drive external sales and growth within the Region and nationally, through ..
Description The Senior Product Manager Conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of ..
Description The Associate Director, Medicaid Implementation (Project Management) manages all aspects of a project, from start to finish, so that it is completed on time and within budget. The Associate Director, ..
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 ..
Job Information Humana Care Manager, Telephonic Behavioral Health 2 - Remote, US in Fargo North Dakota Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with ..
Description The Associate Director, Consumer Experience ensures optimized interaction between a company and members. The Associate Director, Consumer Experience requires a solid understanding of how organization capabilities interrelate across department(s). Responsibilities ..
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 Associate Director, Credentialing/Compliance manages the Dental Credentialing and Compliance team ensuring that dental providers are Credentialed/Re-credentialed according to CMS and State guidelines and that Humana's Dental Networks operate in ..
Description The Vendor Management Lead works as liaison between vendors and organization. The Vendor Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities The ..
Description The Director, Provider Contracting- Behavioral Health initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides health insurance. Requires an in-depth understanding of ..
Description The Director, Provider Contracting- Behavioral Health Medicaid initiates, negotiates, and executes physician, hospital, and/or other provider behavioral health contracts for an organization that provides managed Medicaid health insurance. Requires an ..
Description Humana Military, a wholly-owned subsidiary of Humana Inc. headquartered in Louisville, KY, partners with the Department of Defense to administer the TRICARE health program for military members, retirees and their ..
Description The Hospital Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Hospital Contracting Executive works on problems ..
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 Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Director, Provider Reimbursement is responsible for the leadership, strategy development and execution of Humana Military's provider reimbursement methodologies. This leader is responsible for timely and accurate implementation of Government ..
Description The Director of User Acceptance Testing (UAT) drives performance and collaboration across the enterprise with the goal of ensuring user acceptance testing teams drive and deliver quality testing results based ..
... to Medicare/Medicaid/TRICARE product implementation, operations, contract compliance, and federal contract application submissions. The Director, Market ... internally and externally. Develop a contract management oversight process that allows ... allows..
