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Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..
Job Information Humana Contract Tools, Education, Processes Professional - Louisville, KY or Remote (EST hours) in Lima Ohio Description The Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and ..
Job ID 21000LTHAvailable Openings 1 PURPOSE AND SCOPE: Executes secretarial and administrative assignments of confidential nature and relieves management of clerical, administrative and business detail as necessary. Performs standard administrative functions ..
Description The Medical Coding Coordinator 3 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Job ID 21000LWUAvailable Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..
Description The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems ..
Description Humana Healthy Horizons is seekign a Utilization Management Nurse 2 who utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The ..
Job ID 21000LQSAvailable Openings 1PURPOSE AND SCOPE: Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing Social Work Theory of Human Behavior ..
Description Humana is rapidly evolving from an insurance company with elements of health to a healthcare company with elements of insurance. We are embarking on an ambitious journey to implement a ..
Job Information Humana Manager, Care Management(Behavioral Health) - Ohio Medicaid in Lima Ohio Description Humana Healthy Horizons in Ohio is seeking Managers of Care Management who will lead our behavioral health ..
Description The Senior Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals through analysis and ..
Description This Senior Fraud and Waste Investigator will serve as Humana's Program Integrity Officer, who will oversee the monitoring and enforcement of the fraud, waste, and abuse (FWA) compliance program to ..
Job ID 21000LQSAvailable Openings 1Position Specific Information This role is full-time with beneifits, 30 hours per week during normal business hours. PURPOSE AND SCOPE: Provides psychosocial services to patients treated by ..
Description Humana Healthy Horizons in Ohio is seeking Managers of Care Management (Physical Health & Behavioral Health) who will lead our physical or behavioral health care management operations and staff to ..
Job Information Humana Utilization Management Administration Coordinator in Lima Ohio Description ... Lima Ohio Description The UM Administration Coordinator 2 contributes to administration of utilization management. How we ... is..
Description The Medical Coding Coordinator 2 extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical ..
Description The Senior Application Architect designs and develops IT applications and architects solutions to business problems in alignment with the enterprise architecture direction and standards. The Senior Application Architect work assignments ..
Job Information Humana Storage Administrator- Storage and Backup in Lima Ohio Description At Humana we are committed to helping people live healthy and happy through personalized care. Following the same mantra, ..
Job Information Humana Senior Provider Contracting Professional - Remote (EST Hours) in Lima Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and ..
Job Information Humana Senior Provider Contracting Professional - OH Medicaid in Lima Ohio Description The Senior Provider Contracting Professional initiates, negotiates, and executes behavioral health physician, hospital, and/or other provider contracts ..
Description The Care Management Support Assistant 2 contributes to administration of Care Management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal ..
Job Information Humana Quality Improvement Coordinator in Lima Ohio Description The Quality Improvement Coordinator 3 assists in administering and monitoring quality improvement and compliance processes for the Ohio Medicaid program. The ..
Description The Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. The Director, Technology Solutions requires an in-depth understanding of how organization capabilities interrelate across ..
