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... solutions, ensuring the member's utmost health and safety. De-escalation skills are ... solutions, ensuring the member's utmost health and safety. De-escalation skills are ... following heavy or high volume..
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Description The Quality Improvement Professional 1 implements quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation. The Quality Improvement Professional 1 work assignments ..
... appropriate to optimize teams within Health Care Services and/or Home Operations. ... Improvement and Cost-Reduction throughout the Health Care Services and Home Operations ... improvement initiatives in support of..
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 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 The Senior Portfolio Management Professional collaborates with the business portfolio team to align the IT portfolio and demand. The Senior Portfolio Management Professional work assignments involve moderately complex to complex ..
Description The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other ..
Description The Senior Health Information Management Professional ensures data ... for claims errors. The Senior Health Information Management Professional work assignments ... variable factors. Responsibilities The Senior Health Information Management..
Description The Medical Records Retrieval Representative travels to provider offices within the region and scans medical records into a secure system. The records are reviewed by Humana's Coding staff. Travel up ..
Description The Compliance (UM) Lead conducts and summarizes compliance audits. The Compliance (UM) Lead works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities The Compliance (UM) ..
Description The Risk Adjustment Representative 2 (Medical Record Retrieval Rep) performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. Responsibilities Be a part of ..
... years working in a managed health insurance environment 2 or more years ... and cross functional experience within health insurance plan business Management Consulting background ... on social distancing..
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 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 ..
... Qualifications 3 years or more Health Insurance Sales and/or Account Management experience ... Management experience Active Life & Health Insurance License in the state of ... proof of personal..
Description The Large Group Medical Underwriter computes rates for both renewing and prospective moderate to complex group accounts. The Large Group Underwriter 2 work assignments are varied and frequently require interpretation ..
... Qualifications 3 years or more Health Insurance Sales and/or Account Management experience. ... Management experience. Active Life & Health Insurance License in the state of ... healthcare company committed..
