THE LARGEST COLLECTION OF JOBS ON EARTH
insurance
Supports PDF, DOC, DOCX, TXT, XLS, WPD, HTM, HTML files up to 5 MB
Description The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and ..
... role will be the primary analyst supporting the largest Medicaid market ... Medicaid market at Humana. The analyst will independently collaborate with business ... model. This opportunity offers the..
Sign In or Sign Up in seconds to view this job on EmploymentCrossing.
Description The Medical/Financial Risk Evaluation Professional 2 is responsible for supporting the development, implementation and monitoring of medical/financial risk. The Medical/Financial Risk Evaluation Professional 2 work assignments are varied and frequently ..
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 ..
Description Responsibilities The Senior Insurance Product Manager monitors product performance and recommends changes, cost adjustments or resource additions. Engages in product bid filings, implementing product changes, and member communication. Provides timely ..
Description The Senior Pharmacy Claims Professional in the Pharmacy Claim Audit & Review department adjudicates pharmacy claims and process pharmacy claims for payment. The Senior Pharmacy Claims Professional work assignments involve ..
Description The Senior Demand and Portfolio Management Professional collaborates with the business portfolio team to align the IT portfolio and demand. The Senior Demand and Portfolio Management Professional work assignments involve ..
Description The Sr. Consumer Experience Professional performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Sr. Consumer Experience Professional work assignments involve ..
Description The Actuarial Analyst 1, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
Description The Pharmacy Claim Professional 2 in the Pharmacy Claim Audit & Review (PCAR) team conducts reviews on pharmacy claims to assess for recoveries. The Pharmacy Claim Professional 2 work assignments ..
Description The Senior Market Development Professional provides support to assigned health plan and/or specialty companies relative to Medicare, Medicaid, and Commercial product implementation, operations, contract compliance, and federal contract application submissions. ..
Description The Senior Health Information Management Professional ensures data integrity for claims errors. The Senior Health Information Management Professional work assignments involve moderately complex to complex issues where the analysis of ..
Description The Actuarial Analyst 1, Risk and Compliance is responsible for the overall management and oversight of actuaries and/or support staff where activities are concerned with identifying and managing risks. Identifies ..
Description The Actuarial Analyst 2, Pricing is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, ..
Description The Actuarial Analyst 2, General provides actuarial support ... specific product lines. The Actuarial Analyst 2, General work assignments are ... of action. Responsibilities The Actuarial Analyst 2, General..
Description The Market Research Professional 2 performs data analysis supporting learning plans via management and usage of consumer behavioral, demographic, and attitudinal data. The Market Research Professional 2 work assignments are ..
Description The Supervisor, Health Information Management ensures data integrity for claims errors. The Supervisor, Health Information Management works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable ..
Description This Actuarial Analyst 2 role on the Specialty Benefits team will take ownership of our Dental and Vision commercial group (100 lives) renewal reporting and the dental trend analysis. This ..
Description The Humana Pharmacy Solutions traditional Desktop Audit team oversees and manages multiple aspects related to reviewing pharmacy claim submissions for accuracy and appropriateness. Facilitation of discussions with CMS representatives and ..
Description The Call Quality Lead monitors and evaluates the quality of inbound and/or outbound Sales calls with Commercial Brokers and Agencies. Documents quality issues and performance measures. The Call Quality Lead ..
